الفهرس 
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Abstract
Tumors located in the pineal gland region are rare
neo- plasms, constituting 0.5–1 % of all intracranial
tumors. The treatment for the pineal region tumors depends
on tumor histology. Nowadays, germinomas can be cured
by radiotherapy and chemotherapy without surgical
resection but the other pineal region tumors should be
primary treated by surgery. Two microsurgical approaches,
the infratentorial supracerebellar and the occipital
transtentorial, are accepted as the main standard accesses to
the pineal region. Serum and CSF markers contribute to the
diagnosis of pineal parenchymal tumors. CT and MRI arw
used in diagnosis of pineal tumor. The treatment
recommendations are as follows:
1- Pinoblastoma:
Treated like medulloblastoma with maximal safe
resection to determine risk category, then CSI (23.4-39 Gy
+ local boost to 50-55.8 Gy )followed by chemotherapy.
Radiosurgery boost possible for residual disease.
2- Pineocytoma:
Treat like low- grade glioma. Surgery when possible.
If gross total resection, observe if increasing , postopreative
RT (residual+1-1.5cm margin)50-55 Gy.
Summary
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3- Germinoma:
MRI of new axis. RT alone or chemotherapy
followed by RT. prophylactic new axis RT is controversial.
Consider partial cranial fields, whole ventricular irradiation
to (24-30Gy), boost to primary to (45-50Gy). If there is
new axis or sub ependymal spread, or multiple mid line
tumor CSI (24-36Gy)+ primary disease to (45-50Gy).
4- NGGCTs:
Maximal safe resection then platinum based
chemotherapy. MRI and lumber puncture, if negative new
axis , consolidation local RT. If positive new axis, CSI 30-
36 Gy + boost to primary disease 50-54 Gy