Microsurgical management and long-term outcomes of pineal region tumors: A retrospective study

Objectives: Pineal region tumors are surgically challenging lesions due to their deep location and proximity to critical structures especially the galenic system of veins. Careful surgical planning and good microsurgical techniques are important for a good post-operative outcome. The aim of this study was to review the experience of pineal region tumor surgery and patient outcomes in our institution. Materials and Methods: This is an observational retrospective study. Data were collected from the departmental clinico-radiological database and histopathology reports were retrieved from the pathology department. Post-operative outcomes were assessed immediately and on 1–2 years of follow-up or longer whenever possible. Results: A total of 21 patients were operated on over 7 years. All patients except two were operated on by infratentorial supracerebellar approach in the sitting position. Intraoperative air embolism took place in one patient. 3 patients expired in the post-operative period. The remaining 18 patients were followed up over 1–5 years with a median follow-up of 2 years and all except one are doing well including those receiving adjuvant therapy. Conclusion: In our experience, microsurgical gross total excision/near total excision of pineal region tumors is safe and has a favorable post-operative morbidity and long-term outcome profile.