Craniopharyngiomas

Pineal Region Tumors

MRI before microsurgical removal of a
pineal region tumor

Craniopharyngiomas are benign tumors that arise from tissue near the pituitary gland. They can present with symptoms similar to pituitary adenomas such as visual disturbance and endocrine (hormonal) abnormalities. Surgical resection of craniopharyngiomas is the preferred treatment. Although these tumors are benign, they have the potential to return following resection and can be quite difficult to control.

A variety of different tumor types can occur in this region, located at the posterior aspect of the third ventricle near the center of the brain. In adults, many of these lesions will require surgery, especially if they are growing or are obstructing the cerebrospinal fluid outflow pathway and causing hydrocephalus. Surgical management of these tumors can be quite complex.

MRI after microsurgical removal of a
pineal region tumor

Medulloblastomas

As with ependymomas, medulloblastomas often occur in the posterior fossa in children. Preoperative diagnosis between these tumor types is frequently difficult, as the presenting symptoms and MRI appearance may be very similar. The treatment strategy for medulloblastomas is also similar to ependymomas, with surgical resection followed in some cases by radiation and/or chemotherapy.

Hemangioblastomas

Hemangioblastomas are highly vascular, noncancerous tumors that occur most frequently in the cerebellum. They may be associated with an inherited condition called Von Hippel-Lindau disease. People with this condition may have multiple hemangioblastomas as well as tumors or cysts in other organs. Hemangioblastomas can also occur sporadically in patients without this syndrome. Such patients will usually have only one such tumor. These lesions are often associated with a cyst (fluid cavity) that can be much larger than the tumor itself. As with other lesions in the posterior fossa, common symptoms include headache, nausea, and vomiting. If a patient is symptomatic from such a tumor or if it has been noted to grow on subsequent MRI scans, surgery may be indicated. Complete surgical removal of this type of tumor is usually curative and no further treatment is necessary besides follow-up MRI scans.