Pineal region mass

Changed by Frank Gaillard, 1 Jan 2022
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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.

Terminology

The term pinealoma was historically used to refer to both pineal parenchymal tumorstumours and germinomas, which are the two most common categories of primary pineal region tumorstumours 6. Germinomas were sometimes called the "two-cell" pattern type of pinealoma, due to the presence of both lymphocytes and neoplastic germ cells that were reminiscent of teratomas 6. The term pinealoma has since fallen in popularity.

Clinical presentation

SomeMany pineal region lesions (such, especially small ones that do not significantly change in size, such as cysts) are, are typically discovered incidentally but for larger lesions, patients present clinically with symptoms related to mass effect. Compression of the tectal plate may cause a defect in up-gaze (Parinaud syndrome). Compression of the cerebral aqueduct may cause obstructive hydrocephalus.

Radiographic features

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

Differential diagnosis

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

  • -<p><strong>Masses in the pineal region</strong> have a relatively broad differential because of the variety of cell types found in the region.</p><h4>Terminology</h4><p>The term <strong>pinealoma</strong> was historically used to refer to both pineal parenchymal tumors and germinomas, which are the two most common categories of primary pineal region tumors <sup>6</sup>. Germinomas were sometimes called the "two-cell" pattern type of pinealoma, due to the presence of both lymphocytes and neoplastic germ cells that were reminiscent of teratomas <sup>6</sup>. The term pinealoma has since fallen in popularity.</p><h4>Clinical presentation</h4><p>Some lesions (such as cysts) are typically discovered incidentally but for larger lesions, patients present clinically with symptoms related to mass effect. Compression of the <a href="/articles/tectal-plate">tectal plate</a> may cause a defect in up-gaze (<a href="/articles/parinaud-syndrome">Parinaud syndrome</a>). Compression of the <a href="/articles/cerebral-aqueduct">cerebral aqueduct</a> may cause <a href="/articles/obstructive-hydrocephalus">obstructive hydrocephalus</a>.</p><h4>Radiographic features</h4><p>Intrinsic pineal tissue masses tend to cause upward displacement of the <a title="Internal cerebral vein" href="/articles/internal-cerebral-vein">internal cerebral veins</a>. This is in distinction to tentorial meningiomas, which depress the cerebral veins.</p><h4>Differential diagnosis</h4><ul>
  • +<p><strong>Masses in the pineal region</strong> have a relatively broad differential because of the variety of cell types found in the region.</p><h4>Terminology</h4><p>The term <strong>pinealoma</strong> was historically used to refer to both pineal parenchymal tumours and germinomas, which are the two most common categories of primary pineal region tumours <sup>6</sup>. Germinomas were sometimes called the "two-cell" pattern type of pinealoma, due to the presence of both lymphocytes and neoplastic germ cells that were reminiscent of teratomas <sup>6</sup>. The term pinealoma has since fallen in popularity.</p><h4>Clinical presentation</h4><p>Many pineal region lesions, especially small ones that do not significantly change in size, such as cysts, are typically discovered incidentally but for larger lesions, patients present clinically with symptoms related to mass effect. Compression of the <a href="/articles/tectal-plate">tectal plate</a> may cause a defect in up-gaze (<a href="/articles/parinaud-syndrome">Parinaud syndrome</a>). Compression of the <a href="/articles/cerebral-aqueduct">cerebral aqueduct</a> may cause <a href="/articles/obstructive-hydrocephalus">obstructive hydrocephalus</a>.</p><h4>Radiographic features</h4><p>Intrinsic pineal tissue masses tend to cause upward displacement of the <a href="/articles/internal-cerebral-vein">internal cerebral veins</a>. This is in distinction to tentorial meningiomas, which depress the cerebral veins.</p><h4>Differential diagnosis</h4><ul>
  • -<li><a href="/articles/pineal-parenchymal-tumour-with-intermediate-differentiation">pineal parenchymal tumour with intermediate differentiation</a></li>
  • +<li><a href="/articles/pineal-parenchymal-tumour-of-intermediate-differentiation">pineal parenchymal tumour with intermediate differentiation</a></li>

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