Resection Bed Only

Data guiding management of pineal parenchymal tumors of intermediate differentiation (PPTID) are limited because they are rare and difficult to interpret owing to reclassification in 2007. Adjuvant radiation therapy (RT) appears beneficial. In the largest analysis of PPTID, adjuvant RT was associated with improved overall survival, whereas chemotherapy had no impact (1). The leptomeningeal recurrence rate was 11.8%, suggesting that not all patients require craniospinal irradiation (CSI). In a series of histopathologically reviewed pineal parenchymal tumors, none recurred in patients who underwent gross total resection (2).

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