Pineal Gland Mass



Pineal Gland Mass


Karen L. Salzman, MD



DIFFERENTIAL DIAGNOSIS


Common



  • Pineal Cyst


  • Germinoma


  • Pineocytoma


Less Common



  • Teratoma


  • Pineoblastoma


Rare but Important



  • Retinoblastoma (Trilateral)


  • Germ Cell Neoplasms, Malignant NOS


  • Diffuse Astrocytoma, Low Grade


ESSENTIAL INFORMATION


Helpful Clues for Common Diagnoses



  • Pineal Cyst



    • Homogeneous fluid-filled pineal mass


    • May see rim enhancement


    • Most are < 1 cm but may be up to 2 cm


  • Germinoma



    • Most common germ cell tumor (GCT) & pineal tumor


    • Homogeneous, hyperdense mass with enhancement, ± CSF seeding


    • Central, “engulfed” Ca++ classic


  • Pineocytoma



    • Demarcated round or lobular mass, typically with Ca++


    • Strong, homogeneous enhancement


    • May compress adjacent structures, but no invasion


Helpful Clues for Less Common Diagnoses



  • Teratoma



    • 2nd most common GCT & pineal tumor


    • Midline mass containing Ca++, soft tissue, cysts, & fat; variable enhancement


  • Pineoblastoma



    • Highly malignant, primitive embryonal tumor of pineal gland


    • Large, heterogeneous pineal mass with “exploded” peripheral Ca++ & hydrocephalus

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Aug 7, 2016 | Posted by in NEUROLOGY | Comments Off on Pineal Gland Mass

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