Pineal gland tumors in adults account for about 0.4 to 1 % of all intracranial tumors. A wide variety of tumors can occur in the pineal gland. The most common are the pineal parenchymal tumors (pineocytomas, pineoblastomas, and pineal parenchymal tumors of intermediate differentiation), germ cell tumors, and glial tumors. Uncommonly in the pineal gland one may encounter a metastatic tumor, a meningioma or a melanoma.
We here report a case of primary pineal gland melanoma with prolonged survival of 56 weeks after radiotherapy alone. To our knowledge, this is the first reported case of prolonged survival after radiotherapy alone, without surgical intervention or chemotherapy. Contrary to previous reports, our case demonstrates that a pineal melanoma with leptomeningeal dissemination can still yield a better survival with radiation treatment only.