Neurol. praxi. 2019;20(2):121-126 | DOI: 10.36290/neu.2019.099

A current perspective on diagnosing and treating patients with a pineal cyst

MUDr. Martin Májovský, Ph.D., doc. MUDr. David Netuka, Ph.D., prof. MUDr. Vladimír Beneš, DrSc.
Neurochirurgická a neuroonkologická klinika 1. LF UK a ÚVN, Praha

Pineal cysts are benign lesions of the pineal gland whose prevalence in the population reaches as much as 1%. A pineal cyst is most commonly diagnosed on magnetic resonance imaging as a spherical cystic mass dorsally from the third ventricle above the midbrain. The clinical approach to patients with a pineal cyst is very controversial, particularly if they present with nonspecific complaints. In all patients, we consider it important to assure them of a benign nature of their pineal cysts and of a favourable prognosis. The primary therapeutic modality is observation, followed by symptomatic treatment. In a small proportion of patients, surgical treatment can be considered; however, the indication criteria have not been defined clearly.

Keywords: pineal cyst, pineal gland, headaches, sleep, neurosurgery

Published: April 23, 2019  Show citation

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Májovský M, Netuka D, Beneš V. A current perspective on diagnosing and treating patients with a pineal cyst. Neurol. praxi. 2019;20(2):121-126. doi: 10.36290/neu.2019.099.
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References

  1. Al-Holou WN, Terman SW, Kilburg C, Garton HJL, Muraszko KM, Chandler WF, Ibrahim M, Maher CO. Prevalence and natural history of pineal cysts in adults. J. Neurosurg. 2011; 115: 1106-1114. Go to original source... Go to PubMed...
  2. Barboriak DP, Lee L, Provenzale JM. Serial MR imaging of pineal cysts: implications for natural history and follow-up. AJR. Am. J. Roentgenol. 2001b; 176: 737-743. Go to original source... Go to PubMed...
  3. Beneš V, Mohapl M. Symptomatické cysty pineální krajiny - chirurgická léčba. Československá Neurol. a Neurochir. 2001; 64: 280-284.
  4. Bregant T, Rados M, Derganc M, Neubauer D, Kostovic I. Pineal cysts - a benign consequence of mild hypoxia in a near-term brain? Neuro Endocrinol. Lett. 2011; 32: 663-666. Go to PubMed...
  5. Cauley K, Linnell GJ, Braff SP, Filippi CG. Serial follow-up MRI of indeterminate cystic lesions of the pineal region: experience at a rural tertiary care referral center. AJR Am J Roentgenol 2009; 193: 533-537. Go to original source... Go to PubMed...
  6. Cooper ER. The human pineal gland and pineal cysts. J. Anat. 1932; 67: 28-46. Go to PubMed...
  7. Eide PK, Ringstad G. Results of surgery in symptomatic non-hydrocephalic pineal cysts: role of magnetic resonance imaging biomarkers indicative of central venous hypertension. Acta Neurochir. (Wien). 2017; 159: 349-361. Go to original source... Go to PubMed...
  8. Fain JS, Tomlinson FH, Scheithauer BW, Parisi JE, Fletcher GP, Kelly PJ, Miller GM. Symptomatic glial cysts of the pineal gland. J. Neurosurg. 1994; 80: 454-460. Go to original source... Go to PubMed...
  9. Fetell MR, Bruce JN, Burke AM, Cross DT, Torres RA, Powers JM, Stein BM. Non-neoplastic pineal cysts. Neurology 1991; 41: 1034-1040. Go to original source... Go to PubMed...
  10. Fleege M, Miller GM, Fletcher GP, Fain JS, Scheithauer BW. Benign glial cysts of the pineal gland: unusual imaging characteristics with histologic correlation. AJNR. Am. J. Neuroradiol. 1994; 15: 161-166.
  11. Golzarian J, Balériaux D, Bank WO, Matos C, Flament-Durand J. Pineal cyst: normal or pathological? Neuroradiology 1993; 35: 251-253. Go to original source... Go to PubMed...
  12. Hajnsek S, Paladino J, Gadze ZP, Nanković S, Mrak G, Lupret V. Clinical and neurophysiological changes in patients with pineal region expansions. Coll. Antropol. 2013; 37: 35-40. Go to PubMed...
  13. Hasegawa A, Ohtsubo K, Mori W. Pineal gland in old age; quantitative and qualitative morphological study of 168 human autopsy cases. Brain Res. 1987; 409: 343-349. Go to original source... Go to PubMed...
  14. Inoue Y, Saiwai S, Miyamoto T, Katsuyama J. Enhanced high-resolution sagittal MRI of normal pineal glands. J. Comput. Assist. Tomogr. 1994; 18: 182-186. Go to original source... Go to PubMed...
  15. Kalani M, Wilson D, Koechlin N, Abuhusain H, Dlouhy B, Gunawardena M, Nozue-Okada K, Teo C. Pineal cyst resection in the absence of ventriculomegaly or Parinaud's syndrome: clincial outcomes and implications for patient selection. J Neurosurg 2015; 123: 352-356. Go to original source... Go to PubMed...
  16. Koenigsberg RA, Faro S, Marino R, Turz A, Goldman W. Imaging of pineal apoplexy. Clin. Imaging 1996; 20: 91-4. Go to original source... Go to PubMed...
  17. Kreth FW, Schätz CR, Pagenstecher A, Faist M, Volk B, Ostertag CB. Stereotactic management of lesions of the pineal region. Neurosurgery 1996; 39: 280-9-91. Go to original source... Go to PubMed...
  18. Kulkarni AV. Editorial: pineal cyst resection. J. Neurosurg. 2015; 123: 350-351. Go to original source... Go to PubMed...
  19. Májovský M, Řezáčová L, Sumová A, Pospíšilová L, Netuka D, Bradáč O, Beneš V. Melatonin and cortisol secretion profile in patients with pineal cyst before and after pineal cyst resection. J. Clin. Neurosci. 2017: 39. Go to original source... Go to PubMed...
  20. Mandera M, Marcol W, Bierzyńska-Macyszyn G, Kluczewska E. Pineal cysts in childhood. Childs. Nerv. Syst. 2003; 19: 750-755. Go to original source... Go to PubMed...
  21. Mattogno PP, Frassanito P, Massimi L, Tamburrini G, Novello M, Lauriola L, Caldarelli M. Spontaneous regression of pineal lesions: ghost tumor or pineal apoplexy? World Neurosurg. 2016; 88: 64-69. Go to original source... Go to PubMed...
  22. Mena H, Armonda RA, Ribas JL, Ondra SL, Rushing EJ. Nonneoplastic pineal cysts: a clinicopathologic study of twenty-one cases. Ann. Diagn. Pathol. 1997; 1: 11-18. Go to original source... Go to PubMed...
  23. Michielsen G, Benoit Y, Baert E, Meire F, Caemaert J. Symptomatic pineal cysts: clinical manifestations and management. Acta Neurochir. (Wien). 2002; 144: 233-242; discussion 242. Go to original source... Go to PubMed...
  24. Milroy CM, Smith CL. Sudden death due to a glial cyst of the pineal gland. J. Clin. Pathol. 1996; 49: 267-269. Go to original source... Go to PubMed...
  25. Nevins EJ, Das K, Bhojak M, Pinto RS, Hoque MN, Jenkinson MD, Chavredakis E. Incidental pineal cysts: is surveillance necessary? 2016; 90: 96-102.
  26. Nolte I, Brockmann M, Gerigk L, Groden C, Scharf J. TrueFISP imaging of the pineal gland: more cysts and more abnormalities. Clin. Neurol. Neurosurg. 2010; 112: 204-208. Go to original source... Go to PubMed...
  27. Ozmen E, Derinkuyu B, Samanci C, Akmaz Unlu H, Hakan Demirkan T, Hasiloglu ZI, Kuruoglu S, Adaletli I. The prevalence of pineal cyst in patients with cerebral palsy. Diagnostic Interv. Radiol. 2015; 21: 262-266. Go to original source... Go to PubMed...
  28. Pastel D, Mamourian AC, Duhaime AC. Internal structure in pineal cysts on high-resolution magnetic resonance imaging: not a sign of malignancy. J. Neurosurg. Pediatr. 2009; 4: 81-84. Go to original source... Go to PubMed...
  29. Richardson JK, Hirsch CS. Sudden, unexpected death due to 'pineal apoplexy'. Am. J. Forensic Med. Pathol. 1986; 7: 64-68. Go to original source... Go to PubMed...
  30. Sawamura Y, Ikeda J, Ozawa M, Minoshima Y, Saito H, Abe H. Magnetic resonance images reveal a high incidence of asymptomatic pineal cysts in young women. Neurosurgery 1995; 37: 11-5-6. Go to original source... Go to PubMed...
  31. Seifert CL, Woeller A, Valet M, Zimmer C, Berthele A, Tölle T, Sprenger T. Headaches and pineal cyst: a case-control study. Headache 2008; 48: 448-452. Go to original source... Go to PubMed...
  32. Starke RM, Cappuzzo JM, Erickson NJ, Sherman JH. Pineal cysts and other pineal region malignancies: determining factors predictive of hydrocephalus and malignancy. J. Neurosurg. 2016: 1-6.
  33. Tapp E, Huxley M. The histological appearance of the human pineal gland from puberty to old age. J. Pathol. 1972; 108: 137-44. Go to original source... Go to PubMed...




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