page_title: Papillary tumors of the pineal region
section_title: Grading
hierarchical_section_title: Papillary tumors of the pineal region / Diagnosis / Grading
caption_attribution_description: MRI of papillary tumor of the pineal region (PTPR) in an 18-year old boy. Sagittal T1+Gd. Image modified to obscure patient identity.
context_page_description: Papillary tumors of the pineal region were first described by A. Jouvet et al. in 2003 and were introduced in the World Health Organization classification of Central Nervous System in 2007. Papillary Tumors of the Pineal Region are located on the pineal gland which is located in the center of the brain. The pineal gland is located on roof of the diencephalon. It is a cone shaped structure dorsal to the midbrain tectum. The tumor appears to be derived from the specialized ependymal cells of the subcommissural organ. Papillary tumors of the central nervous system and particularly of the pineal region are very rare and so diagnosing them is extremely difficult.
context_section_description: Papillary tumor of the pineal region (PTPR) is a recently described neoplasm that has been formally recognized in the 2007 World Health Organization (WHO) “Classification of Tumors of the Nervous System.” 
  Because these tumors are so rare, at first there was really no way to grade these tumors. Once they were biopsied, they were defined as either malignant, meaning cancerous, or benign, meaning cancer free. After seeing more and more cases of this tumor, they are now determined to be either Grade II or Grade III, according to the WHO classification.
  The mitotic activity varies for these tumors, ranging from 0 to 10 mitoses per 10 high power (x40) fields.
caption: MRI of a papillary tumor of the pineal region in an 18-year-old boy. Sagittal T1+Gd.
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