Purpose or Case Report: The pineal gland is an important structure for human endocrine regulation. The pineal region can be affected by multiple pathologies including tumors. Pineal masses are uncommon in the pediatric population, but the differential diagnosis is broad, ranging from benign cystic lesions such as pineal cysts, to aggressive WHO grade IV tumors like pineoblastoma. The clinical presentation for these masses is variable, including focal neurologic deficits, visual abnormalities and obstructive hydrocephalus. The purpose of the presentation is to depict the most relevant characteristics of these lesions.
Methods & Materials: Selected cases were obtained from the picture acquisition and communication system at an urban children’s hospital and a current literature review of the pineal region masses was conducted. The obtained cases include: Pineal cyst, pineal germ cell tumor, pineocytoma, pineoblastoma and tectal plate tumor.
Results: The broad differential of lesions in the pineal region ranges from benign pathology that requires no additional evaluation, to malignant tumor requiring medical and surgical management. The imaging characteristics of some of these lesions can help determine or alter management.
Conclusions: The pineal region masses demonstrate characteristic features that may help narrow the differential and determine management and surgical approach.The radiologist should be familiar with the broad range of pathology and the factors that may affect the decision of management and surgical approach; however, histological verification is necessary to ultimately determine the diagnosis of most pineal region masses.