Abstract
Pineal gland tumors are rare tumors. According to World Health Organization (WHO)
classification (2016) of the central nervous system, pineal parenchymal tumors of
intermediate differentiation (PPTID) occupied their position between pineocytoma and
pineoblastoma. It is either grade II or III. There are small numbers of reported cases,
so its classification is still a matter of controversy. Here, we report a case of
a 35-year-old man who presented with complaints of headache, nausea, vomiting, and
focal weakness for 1 year. Computed tomography revealed an enhancing mass lesion in
the region of pineal gland along with hydrocephalus. Following operation, histopathology
of excised specimen was done, and it showed cellular tumor. Cells were having larger
nuclei, vesicular chromatin pattern, ample cytoplasm, focal neuropil-like stroma along
with moderate atypia, 3 to 5 mitotic figures per 10 hpf (high-power field), marked
vascular proliferation, and pseudo rosette. Immunohistochemistry was found strongly
positive for glial fibrillary acidic protein (GFAP) and neuron-specific enolase (NSE),
variable for synaptophysin, and negative for neurofilament and epithelial membrane
antigen (EMA). These findings confirmed the diagnosis. As this tumor is rare with
uncertain behavior following available treatment, the case report of PPTID grade III
large cell type may enrich the existing data and is being presented because of its
rarity.
Keywords
pineal parenchymal tumors - pineal parenchymal tumor of intermediate differentiation
- tumor grade III
