Pineoblastoma

Diagnosis

Pineoblastoma diagnosis often involves imaging tests to visualize the brain. Additional tests may include removing tissue or fluid for laboratory analysis.

Imaging tests
Imaging helps determine the location and size of the pineoblastoma. Common tests include:

• Magnetic resonance imaging (MRI), often with advanced techniques such as perfusion MRI or magnetic resonance spectroscopy.
• Computerized tomography (CT) scans.
• Positron emission tomography (PET) scans.

Tissue sample testing
A biopsy removes a small sample of tissue for lab testing. This can be done with a needle before surgery or during surgery. The tissue is examined to determine cell type and growth rate.

Cerebrospinal fluid testing
A lumbar puncture, also called a spinal tap, collects cerebrospinal fluid from around the spinal cord. This fluid is tested for pineoblastoma cells and may be collected during a biopsy procedure.

Treatment

Pineoblastoma treatment usually begins with surgery to remove as much of the tumor as possible, followed by additional therapies to target remaining cancer cells.

Surgery to relieve fluid buildup
If the tumor blocks cerebrospinal fluid flow, surgery may redirect fluid through a drain or tube to relieve pressure. This may be done alongside a biopsy or tumor removal.

Surgery to remove the tumor
A neurosurgeon removes as much of the pineoblastoma as possible. Complete removal may not always be possible due to the tumor’s location near critical brain structures. Additional treatments target remaining cells.

Radiation therapy
Radiation uses high-energy beams from X-rays, protons, or other sources to kill cancer cells. Often, radiation is directed at the entire brain and spinal cord to target potential spread of cancer cells. This is commonly recommended for adults and children over age 3.

Chemotherapy
Chemotherapy uses strong medicines to kill cancer cells. It is usually given after surgery or radiation, sometimes concurrently with radiation, or before surgery to shrink larger tumors.

Radiosurgery
Stereotactic radiosurgery focuses multiple radiation beams precisely to destroy cancer cells. It may be used if pineoblastoma recurs after initial treatment.