Pineal gland metastasis is a rare site of metastatic disease. 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 tumors 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.
Pineal gland metastases are mostly due to the spread of primary carcinomas of the 1:
- gastrointestinal tract
- bladder 4
- pancreas 5
- ovary 6
- testis 7
All the masses that may affect the pineal region are considered among the differential diagnosis. There are no specific imaging features for metastasis to the pineal gland itself. The clinical history and the concomitant leptomeningeal carcinomatosis play 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
- 4. Li J, Wang P, Wang B. Unique Case Report of Pineal Gland Metastasis From Bladder Carcinoma. (2016) Medicine. 95 (18): e3622. doi:10.1097/MD.0000000000003622 - Pubmed
- 5. Naugler C, Xu Z. Pancreatic adenocarcinoma metastatic to the pineal gland. (2008) Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 15 (11): 1284-6. doi:10.1016/j.jocn.2007.08.022 - Pubmed
- 6. P Weber, Kirk V. Shepard, S Vijayakumar. Case report. Metastases to pineal gland. (1989) Cancer. 63 (1): 164. doi:10.1002/1097-0142(19890101)63:1<164::AID-CNCR2820630126>3.0.CO;2-J
- 7. Delahunt B, Teoh HH, Balakrishnan V, et al. Testicular germ cell tumor with pineal metastases. (1990) Neurosurgery. 26 (4): 688-91. Pubmed
Related Radiopaedia articles
Pineal region masses
The pineal region is anatomically complex and plays host to a number of unique masses and tumors as well as potentially affected by many entities seen more frequently elsewhere in the brain.
- cystic non-neoplastic lesions
- pineal parenchymal tumors
- germ cell tumors
- tumors also encountered in the pineal region
- pineal gland metastases
- vascular lesions