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Pineal region mass

Dr Frank Gaillard et al.

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
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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The pineal region is anatomically complex and plays host to a number of unique masses and tumours as well as potentially affected by many entities seen more frequently elsewhere in the brain.