Since 1976, surgical approaches to the pineal region have been undertaken at Groote Schuur Hospital. Thirty cases presenting with a clinical and investigative diagnosis of pineal tumour have been reviewed with respect to epidemiology, surgery, histological subtypes and metastatic pattern. The postoperative management with radiotherapy in the different histological subtypes is discussed. The prognosis for germ cell and benign tumours is good, with 100% control, but pineal parenchymal tumours and astrocytomas have not fared as well.

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