The masses of the pineal gland can be found incidentally in MRI in 1.4-10% of the cases, at autopsy the prevalence can increase up to 40%. The most frequent masses are cysts, followed by tumors and vascular lesions. According to the World Health Organization (WHO), tumors can be divided into germ cell tumors and non-germinomatous tumors including teratomas, embryonal carcinoma, yolk sac tumors, choriocarcinoma, and mixed germ cell tumors. The two most frequent are germinoma in 50-60% of cases and teratoma in 15%.