BACKGROUND
Pineal gland tumors are rare
central nervous system tumors, and while
neck pain and
headaches may be common among those who have had these
tumors removed, there is little research regarding management of these symptoms. CASE REPORT A 45-year-old man with a history of pineal
germinoma treated with
pinealectomy,
chemotherapy,
radiation therapy, and
ventriculoperitoneal shunt placement at age 21 presented with chronic
neck pain and
headaches, which initially improved following his surgery and concurrent
therapies, yet progressively worsened over the following years. He required thyroid and
testosterone medication because of radiation-induced
hypopituitarism, yet was employed, and until recently, active with playing tennis. He had previously seen his primary care provider, orthopedist, and neurologist, and had been cleared of severe pathology via brain magnetic resonance imaging and was referred to the chiropractor. On examination, the patient had severely limited passive cervical spine range of motion, yet hat no
neurologic deficits, and radiographs showed mild
cervical spondylosis and cervicothoracic
scoliosis. His history and presentation were suggestive of
radiation-induced fibrosis. The patient's
neck pain,
headaches, and quality of life improved with
multimodal treatments including spinal and soft-tissue manipulation, stretches, and yoga. CONCLUSIONS This case illustrates long-term sequelae of a
pineal gland tumor and its treatment, including
neck pain and
headache, and improvement with multimodal chiropractic
therapies. Despite the success in this case, these results are not broadly generalizable. Further research is needed to understand the natural history of symptoms and effectiveness of multimodal
therapies among patients who have had
pineal tumor surgery.