A well-circumscribed lobulated lesion with cystic areas occupies the pineal region, compressing the tectum anteriorly with obstruction of the aqueduct of Sylvius. The mass displays hyperintense signal in non-contrast T1 WI, hyperintense signal on T2 and FLAIR images with central area of calcification - returns low signal in all pulse sequences (engulfed pineal gland). It also exhibits strong homogenous enhancement after IV contrast. VP shunt is well placed.
