Low-Level Cerebrospinal Fluid β-hCG Elevation in Patients with Pineal Parenchymal Tumors: A Four-Case Series and Diagnostic Caution

Vollständiger Abstract

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Background: Pineal region tumors (PRTs) are rare and biologically heterogeneous neoplasms with overlapping clinical and radiological features. Low-level cerebrospinal fluid (CSF) beta-human chorionic gonadotropin (β-hCG) may support a clinical diagnosis of germinoma (GE); however, its pathological specificity remains uncertain. Methods: We retrospectively reviewed four patients with low-level CSF β-hCG elevation whose available tissue specimens demonstrated pineal parenchymal tumors (PPTs). Tissue was obtained before systemic treatment in two patients and after platinum-based chemotherapy in two. Results: All four patients were male and aged 8 to 19 years. Pretreatment specimens from two patients demonstrated pineal parenchymal tumors of intermediate differentiation (PPTID), whereas postchemotherapy specimens from the other two demonstrated pineoblastoma (PB). Serum β-hCG was