Treatment of the Pinealoma: Experience from a Rare Case
Introduction: Pinealoma is an extremely rare type of neuroendocrine tumor without evidence-based systemic therapy.
Aim(s): To share our experience of treatment for a patient with pinealoma.
Materials and methods: A 46-year old man, who underwent a surgery because of pinealoma 15 years ago, visited our center because of recurrent high temperature, fatigue and severe anemia. A mass located at the posterior pineal region was found on MRI. 68Ga-DOTANOC-PET/CT and 18F-FDG-PET/CT scan showed that the mass and multiple bone metastasis significantly expressed somatostatin receptors and harbored high uptake of FDG. Immunohistochemistry re-confirmed the surgical specimens as a pinealoma with a Ki-67 index of 1%. Bone marrow biopsy was performed which was further diagnosed as metastatic neuroendocrine tumor. After a multidisciplinary discussion, pinealoma with meninges and bone marrow metastasis was diagnosed, and then 40mg octreotide LAR was injected monthly to control the clinical symptoms. The disease remained stable for 7 months. But CT scan reveled tumor progression 7 months later. Thus, the dosage of octreotide LAR was increased to 60mg/month and interferon alfa (180µg/week) was additionally combined.
Conference: 17th Annual ENETSConcerence (2020)
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