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 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 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
- 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