Turkish Neurosurgery 2015 , Vol 25 , Num 2
Primary Pineal Malignant Melanoma - Illustrated Review
Ahitagni BISWAS1, Pritee B CHAUDHARI1, Sujith Kumar M1, Elanthenral SIGAMANI2, Meher Chand SHARMA2, Samir Kumar KALRA3, Pramod Kumar JULKA1, Goura Kishor RATH1
1All India Institute of Medical Sciences, Departments of Radiotherapy and Oncology, New Delhi, India
2All India Institute of Medical Sciences, Departments of Pathology, New Delhi, Indiaz
3Sir Ganga Ram Hospital, Department of Neurosurgery, New Delhi, India
DOI : 10.5137/1019-5149.JTN.6568-12.1 AIM: Primary pineal melanoma is a rare tumor. We herein review the histogenesis, pathology, radiology and therapeutic options of this rare tumor.

MATERIAL and METHODS: We conducted a PUBMED search using a combination of keywords such as “primary pineal melanoma”, “CNS melanoma”, and “pineal tumor” and identified 16 cases of primary pineal melanoma. Clinical features, pathologic characteristics and treatment details of these patients were noted from respective case reports. We also describe a case of a 45-year-old Indian woman with primary pineal melanoma treated with a combination of surgery and post-op radiation.

RESULTS: The median age at presentation is 50 years. Median duration of symptoms is 6 weeks. Common symptoms at presentation include headache (58.8%), personality changes (41.2%), gait disturbance (35.3%) and Parinaud’s syndrome (29.4%). Surgery, radiotherapy and chemotherapy have been used in 29.4%, 47.1% and 23.5% of patients respectively. Median overall survival is 56 weeks. Leptomeningeal dissemination and ventricular ependymal spread were noted in 70.6% and 35.3% patients, respectively.

CONCLUSION: Combined modality treatment comprising maximal safe surgery and post-operative radiation should be preferred in patients with localized pineal melanoma without leptomeningeal dissemination. Taking a cue from other subsites of melanoma, chemotherapy can perhaps be deferred until recurrence. Keywords : Primary, Pineal, Melanoma, Tumor

Corresponding author : Ahitagni Bswas, dr_ahitagni@yahoo.co.in