Some features of each of these malignancies may be useful to help distinguish between them. Pineocytomas can be differentiated from pineoblastomas based on the presence of small cells with a moderate amount of cytoplasm, rare to no mitoses, strong staining for synaptophysin, and obvious synapses on electron microscopy examination. Glial neoplasms tend to stain strongly with GFAP while pineoblastomas demonstrate inconsistent positivity. Therapeutic management of adults with pineoblastomas is controversial since such few cases exist in the literature. A combination of radiotherapy and chemotherapy is usually attempted.
Prognosis is dismal regardless of therapy regimen.
Histologically confirmed pineal tumors and other germ cell tumors of the brain.