Surgical outcome of pineal region lesions in paediatric population

Introduction. Pineal region pathologies are heterogenous, spectrum ranging from benign, infective to malignant in nature such as parenchymal, germ cell, glial, melanomas, metastatic, tubercular, etc. These lesions are commoner in the pediatric age group and have a variable outcome. The goal of this study is to present our experience regarding the surgical outcomes of pineal region lesions in the paediatric population. Objective. The objective of this study is to access the surgical outcome of pineal region lesions in the paediatric population Methods and Material. Eighty cases of pineal region lesions in the paediatric population (upto 15 years of age) operated in the neurosurgery department, G.B Pant Hospital New Delhi via either Occipital transtentorial or Supracerebellar Infratentorial approaches were retrospectively analyzed. Results. There were four main groups of lesions with pineal parenchymal tumours (35 cases) being the commonest. Glial tumours were the next most common contributing 29 cases. Germ cell tumours comprise 7 and miscellaneous 9 cases. The outcome showed graded improvement with the extent of tumour removal and 57 patients(71.25%) improved following surgery. The clinical status of 20 patients(25%) remained unchanged and 3(3.75%) deteriorated from their pre-operative status. 3 patients(3.75%) died in the immediate post-operative period and 11(13.75%) died due to recurrent disease. Conclusion. A graded increase in survival was noted with increasing the degree of resection and postoperative adjuvant therapy in malignant pineal tumours whereas benign pineal lesions can be managed with surgery. Pure germinomas are the only tumour for which the survival rate was unrelated to extent of tumour resection