The dangers of pineal cysts in children

Cyst is a disease symptom that occurs in many people. Some are benign, while others are malignant. Patients should pay attention to examination and timely treatment. Children are also at risk of developing cysts, and we must be aware of the dangers of pineal cysts in children. We must first conduct a correct examination to determine whether it is benign or malignant. This type of pineal cyst is more common in children and less common in adults, so it is easier to diagnose.

1. The dangerousness of pineal cyst determines its benign or malignant nature. There are many types of cysts. Cysts in a narrow sense generally refer to simple cysts, which belong to the benign category. Cysts in a broad sense can be tumorous. So there could be something malignant. However, attention should be paid to the nature, size, and development of the cyst.

2. This disease is more common in children and less common in adults.

Classification of Pineal Region Tumors:

(I) Tissue and blood classification

1. Germ cell tumors: germ cell tumor, teratoma, embryonal cell tumor, choriocarcinoma

2. Tumors of pineal cell origin: pineocytoma, pineoblastoma

3. Other cell-derived tumors: glioma, meningioma, etc.

4. Cysts: including simple cysts, dermoid cysts, etc.

Among these, germ cell tumors are the most common, accounting for 60% to 80%, followed by pineal cell tumors.

(ii) According to radiosensitivity, tumors are divided into highly sensitive ones, including germ cell tumors, pinealoblastoma, etc.; moderately sensitive ones include gliomas and pinealocyte tumors; insensitive ones include teratomas, cysts, and meningiomas. Among them, highly sensitive ones are the most common, reaching 75% to 80%.

Clinical manifestations

1. Increased intracranial pressure: headache, vomiting, and also decreased vision, abducens nerve paralysis, etc.

2. Inability to look up and hearing impairment

3. Unstable gait and slow coordination

4. Urinary incontinence

5. Germ cell tumors may present as precocious puberty; pineal cell tumors may present as stagnation or agenesis of sexual characteristics.

Treatment for tumors in this area should be comprehensive: conventional radiotherapy, gamma knife therapy, drug therapy and surgical treatment; biopsy methods for clear pathology include stereotactic biopsy and neuroendoscopic biopsy.

Germ cell tumors are highly sensitive to radiotherapy. The purpose of surgery is only to clarify the pathology and provide sufficient basis for radiotherapy. Generally, the diagnosis can be confirmed based on typical clinical manifestations, clinical tests and imaging features, and those with high suspicion can undergo experimental radiotherapy. It is internationally recognized that germ cell tumors can achieve long-term survival through a combination of radiotherapy and chemotherapy. Many children have received our systematic combined radiotherapy and chemotherapy and are now attending or have graduated from college. However, many clinicians have not yet realized this and have given up treatment once the diagnosis of germ cell tumors is confirmed. It is indeed a pity.

For pinealoma, glioma, etc., because they are moderately sensitive to radiotherapy, it is recommended to first remove most of the tumor through surgery, clarify the nature of the tumor, and relieve clinical symptoms, and then cooperate with conventional radiotherapy or gamma knife treatment. For teratoma, meningioma, cyst, etc., because they are not sensitive to radiotherapy, it is often recommended to completely remove the tumor through surgery, which is very effective. However, due to the different experiences and technical levels of the surgeons, the surgical results vary greatly.