Pineal gland metastases are rare and mostly related to primary carcinomas of the lungs, breast, gastrointestinal tract, and kidneys. They usually occur concomitantly with leptomeningeal metastases.
The real incidence of pineal metastasis is not clear, studies have reported a prevalence of 0.4 to 3.8% in patients with metastatic solid tumours 1.
Pineal metastases are usually asymptomatic unless a certain volume is reached, then causing a local mass effect that may manifest as a Parinaud syndrome or increased intracranial pressure symptoms related to obstructive hydrocephalus 1,3.
All the masses that may affect the pineal region are considered among the differential diagnosis. There are no specific imaging features for a metastasis to the pineal gland itself, with the clinical history and the concomitant leptomeningeal carcinomatosis playing a more important role in this scenario.
- 1. Smith AB, Rushing EJ, Smirniotopoulos JG. From the archives of the AFIP: lesions of the pineal region: radiologic-pathologic correlation. Radiographics. 2010;30 (7): 2001-20. Radiographics (full text) - doi:10.1148/rg.307105131 - Pubmed citation
- 2. Norden AD, Reardon DA, Wen PY. Primary Central Nervous System Tumors. Springer Science & Business Media. (2010) ISBN:160761166X. Read it at Google Books - Find it at Amazon
- 3. Debois J. TxNxM1. Springer Science & Business Media. (2006) ISBN:0306476789. Read it at Google Books - Find it at Amazon
Pineal region masses
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.
- cystic non-neoplastic lesions
- pineal parenchymal tumours
- germ cell tumours
- tumours also encountered in the pineal region
- pineal gland metastases
- vascular lesions