Pineal Region Masses

Front 1

Germ Cell Tumor (Germinomas)

Back 1

Well-defined, usually midline masses most commonly in the pineal region.
Peak incidence around puberty
In pineal region, males more commonly affected than females.
No gender predilection for those occuring in supracellar region.
Isodense to hyperdense well circumscribed mass on CT. Engulfment of the normal physiologic calcification compared to the exploded appearance most commonly seen in pineal parenchymal tumors.
Dark on T1 and bright on T2
Intense enhancement on CT and MR.

Hint 1

clinical presentation related to compression by the mass on the sylvian aqueduct producing hydro or to compression of the superior colliulus, producing parinaud syndrome

Front 2

pineoblastoma

Back 2

Histologically and radiographically similar to medulloblastoma.
Primarily in young kids.
Rarely well circumscribed and often demonstrates a lobular contour, local invasion and frequent calcification.
CSF spread is common, WHO grade 4.
Isodense to hyperrdense on CT. MR usually isointense to hypointense on T1.

Front 3

Pineocytoma

Back 3

Most common in adults.
Usually well demarcated, noninvasive and slow growing. Often calcified.
Isodense to hyperdense on CT. on MR usually isointense

Front 4

Pineal cysts

Back 4

Internal signal intensity similar to CSF