Pineal region mass

Changed by Ammar Haouimi, 20 Nov 2018

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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 and may cause a defect in up-gaze (Parinaud syndrome) or obstructive hydrocephalus, if the cerebral aqueduct is compressed.

Intrinsic pineal tissue masses also tend to cause upward displacement of the internal cerebral veins. This is in distinction to tentorial meningiomas which depress the cerebral veins.

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 the pineal gland
pineal metastasis
pineal cyst
inclusion cysts (dermoid / epidermoid) ⁴
meningioma near the pineal region
other rare entities
- cavernoma in the pineal region
- vein of Galen aneurysm

If invasive, a tectal plate mass may be difficult to distinguish from a pineal mass.

~~-<li><a href="/articles/pineal-gland-metastases">pineal metastasis</a></li>~~
+<li><a href="/articles/pineal-gland-metastasis-1">pineal metastasis</a></li>
+<li>inclusion cysts (dermoid / epidermoid) <sup>4</sup>
+</li>

References changed:

4. Wolfgang Dähnert. Radiology Review Manual. (2011) <a href="https://books.google.co.uk/books?vid=ISBN9781609139438">ISBN: 9781609139438</a><span class="ref_v4"></span>

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