Pineal region mass
Masses in the pineal region have a relatively broad differential because of the variety of cell types found in the region.
If large enough, the mass may compress the tectal plate which may cause a defect in up-gaze (Parinaud syndrome) or, obstructive hydrocephalus if the cerebral aqueduct is compressed.
Differential diagnosis
-
pineal parenchymal tumours
- pineocytoma: mature well-differentiated tumour : WHO grade II
- pineal parenchymal tumour with intermediate differentiation
- pineoblastoma: malignant, primitive tumours : WHO grade IV
- papillary tumour of the pineal region
-
germ cell tumours
- pineal germinoma (most common; ~ 50% of all tumours)
- pineal embryonal carcinoma
- pineal choriocarcinoma
- pineal yolk sac carcinoma - endodermal sinus tumour
- pineal teratoma
- astrocytoma of pineal gland
- pineal metastasis
- pineal cyst
- meningioma near pineal region
- other rare entities
- cavernoma in pineal region
- aneurysm in pineal region
If invasive then a tectal plate mass may be difficult to distinguish from a pineal mass.
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