Pineal Tumor Surgery and Treatment in New Jersey

A patient who has been diagnosed with a pineal tumor worries about what is next in their treatment journey. At Centers for Neurosurgery, Spine & Orthopedics (CNSO), the medical staff features neurosurgeons and other specialists highly skilled in brain and spine treatments including surgeries. This passionate group of experts educates patients on their diagnosis, explains the most effective treatment options, and ensures patients understand their expected course toward wellness. With locations throughout northern New Jersey, CNSO helps make treatment more accessible to patients. Here, CNSO explains more about pineal tumors and the types of treatment available.

What Is a Pineal Gland Tumor?

As the name suggests, a pineal gland tumor forms in the pineal gland, which is a tiny gland in the middle of the head surrounded by the brain. The pineal gland produces melatonin, a hormone that affects a person’s sleep and wake cycles. Pineal tumors are very rare. When they appear, it typically is in children or adults under 40.

Types of Pineal Gland Tumors

Pineal gland tumors are grouped by grade, with Grade I being the slowest-growing type, and Grade IV being the most aggressive and fastest-growing type. Varieties of pineal tumors include:

Pineocytoma

This type of tumor grows from the pinealocytes, or the main cells in the pineal gland. These are slow-growing tumors, usually graded as I or II. They are typically benign and easily removed through surgery. These tumors usually appear in adults between the ages of 20 and 64 but can happen to a person at any age. People with pineocytomas tend to have a positive prognosis.

Pineal Parenchymal Tumor

Known as mixed pineal tumors, these come from a combination of different cells inside the pineal gland. They are intermediate-grade tumors that usually are Grade II or III. This type of tumor can happen at any age.

Papillary Pineal Tumor

Papillary pineal tumors develop from the cells that line the brain’s cavities and the central canal of the spinal cord. These are intermediate-grade tumors of Grade II or III.

Pineoblastoma

These are very rare, aggressive, and fast-growing Grade IV tumors that are almost always cancerous. These tumors most often affect people under the age of 20.

Mixed Pineal Tumor

These tumors are a combination of slow- and fast-growing cells. They can be any grade.

A pineal tumor is not always cancerous. However, this type of tumor can still cause troubling symptoms because of its location. A pineal tumor may press against the brain as it grows, which creates painful pressure on the skull. It can also block the flow of cerebral spinal fluid, which cushions the brain. If this happens, the pressure on the skull may increase.

Symptoms of a Pineal Gland Tumor

Most people who are diagnosed with a pineal gland tumor report feeling pressure inside of their skull. The other common symptom is hydrocephalus, or the build-up of cerebrospinal fluid in the brain. Other symptoms include:

• Balance or coordination problems
• Headaches
• Memory problems
• Nausea and vomiting
• Tiredness
• Trouble with eye movements
• Vision changes

Since the symptoms of a pineal gland tumor can look a lot like signs of other health problems, it is important to seek an expert diagnosis.

How to Diagnose a Pineal Gland Tumor

The first thing a neurosurgeon at CNSO will do is perform a physical examination and ask a patient about their overall health history. A neurological exam also may be performed, where a medical professional will test for:

• Balance
• Coordination
• Eye movement
• Motor function
• Reflexes
• Sensations

After those base-line tests are done, a neurosurgeon may use one or more of the following tests to gain more information:

• Magnetic resonance imaging (MRI) scan: An MRI is one of the most common and preferred ways to scan for pineal gland tumors. An MRI uses magnets and radio waves to create detailed images of the spinal cord and brain.
• Computed tomography (CT) scan: A CT scan is another form of imaging that uses X-rays and a computer to create pictures of the brain. This enables neurosurgeons to identify the tumor’s location and see surrounding structures.
• Biopsy: A brain specialist removes a small number of tumor cells for examination. A biopsy can determine the type and grade of a pineal tumor.
• Blood tests: A doctor may take blood samples to test for biochemical markers of pineal tumors. A sample of cerebrospinal fluid also may be collected for testing.

Treatment for a Pineal Gland Tumor

The most effective treatment for a pineal tumor depends on the size, location, type, and grade of the tumor. The type of treatment can also depend on whether the tumor is pushing on the brain and creating pressure in the skull.

In most cases of a pineal brain tumor, surgery is not necessary. In other cases, brain surgery is necessary for resolving the symptoms of a pineal tumor. Some patients may undergo chemotherapy or radiation therapy alongside surgery. The type of brain surgery may be a minimally invasive endoscopic procedure, or the common craniotomy. During this procedure, the neurosurgeon removes a small part of the skull to access the tumor and remove it.

There are several approaches to craniotomy, including endoscopic craniotomy, which involves making a small incision into the skull and using a fiberoptic scope and camera to guide the procedure. This approach reduces disturbance to surrounding tissue and often allows for a quicker recovery. Stereotactic craniotomy helps differentiate between healthy and unhealthy tissue, as neurosurgeons use an MRI or CT scan as a guide.

Surgery often can eradicate a benign tumor, but for malignant and more advanced pineal tumors, removing it entirely without damaging the surrounding tissue can be difficult. However, even the partial removal of a tumor during surgery often improves the effectiveness of subsequent treatments.

CNSO focuses on minimally invasive brain surgery. Minimally invasive surgery achieves the same or better results than traditional brain surgery but with less damage because there is no need to cut through muscle and tissue.

A minimally invasive procedure usually involves an incision of two centimeters or less where a small tube is inserted. The tube holds a microscope, light, camera, and precision tools that the neurosurgeon uses to perform the procedure. For pineal tumor surgery, a keyhole craniotomy is a minimally invasive alternative to other procedures.

See a Specialist for Pineal Tumor Diagnosis at CNSO

The dedicated surgical and non-surgical team at Centers for Neurosurgery, Spine & Orthopedics understands how any type of brain tumor can impact daily life. At CNSO, patients receive comprehensive and coordinated care so they can resume a healthy, less painful lifestyle free from disability. The team includes leading board-certified neurosurgeons, orthopedic spine surgeons, interventional pain management physicians, physiatrists, rehabilitation specialists, and certified physical therapists.

Centers for Neurosurgery, Spine & Orthopedics offers multiple convenient locations across northern New Jersey, including in Bergen, Passaic, Essex, Morris, Hudson, Union, Middlesex, and Monmouth counties. Northern New Jersey patients can contact CNSO today to learn more about treatment for pineal gland tumors and other brain conditions.