Pineal gland metastasis

Last revised by Dr Bahman Rasuli on 19 May 2021

Pineal gland metastasis is a rare site of metastatic disease. They usually occur concomitantly with leptomeningeal metastases.

This article will discuss metastatic lesions affecting only the pineal gland. For other intracranial metastatic locations, please refer to the main article on intracranial 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:

  • lung
  • breast
  • gastrointestinal tract
  • kidneys
  • 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. 

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Cases and figures

  • Case 1: renal cell carcinoma
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  • Case 2: lung cancer
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