诊断
Pineoblastoma diagnosis often involves imaging tests to make pictures of the brain. Other tests might involve removing tissue and fluid for testing.
Imaging tests
Imaging tests can find the location and size of the pineoblastoma. Magnetic resonance imaging, also called MRI, is often used to diagnose brain tumors. Advanced techniques also may be used. These could include perfusion MRI and magnetic resonance spectroscopy.
Additional tests might include computerized tomography scans, also called CT scans, and positron emission tomography scans, also called PET scans.
Removing a sample of tissue for testing
A biopsy is a procedure to remove a sample of tissue for testing in a lab. It can be done with a needle before surgery. Or the sample can be removed during surgery. The tissue sample goes to a lab for tests. The results might show the types of cells and how quickly they are growing.
Removing cerebrospinal fluid for testing
A lumbar puncture is a procedure to remove a sample of the fluid around the brain and spinal cord. This procedure also is called a spinal tap. To get the fluid, a healthcare professional inserts a needle between two bones in the lower spine. The health professional uses the needle to remove some cerebrospinal fluid from around the spinal cord. The fluid is tested to look for pineoblastoma cells. Cerebrospinal fluid also may be collected during a biopsy to remove tissue from the brain.
治疗
Pineoblastoma treatment usually involves surgery to remove as much of the cancer as possible. Additional treatments also may be recommended.
Surgery to relieve fluid buildup in the brain
A pineoblastoma may grow big enough to block the flow of cerebrospinal fluid. This puts pressure on the brain. An operation can redirect the fluid through a drain or tube. This helps relieve the pressure. This procedure may be done at the same time as a biopsy or surgery to remove the pineoblastoma.
Surgery to remove the pineoblastoma
A brain surgeon, also called a neurosurgeon, works to remove as much of the pineoblastoma as possible. Sometimes all of the cancer can't be removed. This is because pineoblastoma forms near important structures deep inside the brain. More treatments after surgery are usually needed. These treatments target the remaining cells.
Radiation therapy for pineoblastoma
Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources. During radiation therapy, a machine directs beams to the brain and spinal cord. Extra radiation is directed at the cancer cells.
Radiation is often given to the entire brain and spinal cord. This is because the cancer cells can spread from the brain to other parts of the central nervous system. This treatment is often recommended for adults and children older than age 3.
Chemotherapy for pineoblastoma
Chemotherapy treats cancer with strong medicines. For pineoblastoma, chemotherapy is usually used after surgery or radiation therapy. Sometimes it's used at the same time as radiation therapy. For larger pineoblastomas, chemotherapy may be used before surgery. This might shrink the cancer and make it easier to remove.
Radiosurgery for pineoblastoma
Stereotactic radiosurgery focuses multiple beams of radiation on exact points to kill cancer cells. Radiosurgery is sometimes used to treat pineoblastoma that comes back after treatment.
Clinical trials
Clinical trials are studies of new treatments. These studies offer a chance to try the latest treatment options. Side effects from these treatments may not be known. Ask your child's healthcare professional whether your child might be able to participate in a clinical trial.
准备您的预约
Make an appointment with your usual doctor or other healthcare professional if you or your child have any symptoms that worry you. If your health professional thinks that you or your child might have pineoblastoma, you may be referred to a specialist. This might be a cancer doctor, called an oncologist. You also may see a surgeon who specializes in operating on the brain, called a neurosurgeon.
Appointments can be short and being prepared can help. Here's some information that may help you get ready.
What you can do
When you make the appointment, ask if there's anything you need to do in advance, such as fasting before having a specific test. Make a list of:
- Your symptoms, including any that seem unrelated to the reason for your appointment.
- Key personal information, including major stresses, recent life changes and family medical history.
- All medications, vitamins or other supplements you take, including the doses.
- Questions to ask your doctor.
Take a family member or friend along, if possible, to help you remember the information you're given.
For pineoblastoma, some basic questions to ask your doctor include:
- Do I have cancer?
- Do I need to have the cancer removed?
- Has the cancer spread?
- Do I need more tests?
- What are my treatment options?
- What are the potential risks for these treatment options?
- Do any of the treatments cure my cancer?
- Can I have a copy of my pathology report?
- How much time can I take to consider my treatment options?
- Are there brochures or other printed materials that I can take with me? What websites do you recommend?
- What would happen if I choose not to have treatment?
Don't hesitate to ask other questions.
What to expect from your doctor
Your doctor is likely to ask you several questions, such as:
- When did your symptoms begin?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?