Book contents
- Frontmatter
- Dedication
- Contents
- Preface
- Case 1 Dense basilar artery sign
- Case 2 Global anoxic brain injury
- Case 3 Acute infarction
- Case 4 Vertebral artery dissection
- Case 5 Subacute infarct
- Case 6 Subarachnoid hemorrhage
- Case 7 Intracranial aneurysms
- Case 8 Giant aneurysms
- Case 9 Acute intracerebral hematoma
- Case 10 Cerebral amyloid angiopathy
- Case 11 Primary CNS vasculitis
- Case 12 Reversible cerebral vasoconstriction syndrome
- Case 13 Moyamoya disease/syndrome
- Case 14 Cortical venous thrombosis
- Case 15 Developmental venous anomalies
- Case 16 Dural arteriovenous fistula
- Case 17 Cavernous malformation
- Case 18 Tumefactive demyelinating lesion
- Case 19 Acute disseminated encephalomyelitis
- Case 20 Progressive multifocal leukoencephalopathy
- Case 21 Osmotic myelinolysis
- Case 22 Neurosarcoidosis
- Case 23 Posterior fossa masses in children
- Case 24 Low-grade glioma
- Case 25 Diffuse intrinsic pontine glioma
- Case 26 Pseudoprogression of GBM
- Case 27 Pseudoresponse in treatment of GBM
- Case 28 Low-grade oligodendroglioma
- Case 29 Primary CNS lymphoma
- Case 30 Pineal region tumors
- Case 31 Intraventricular masses
- Case 32 Colloid cyst
- Case 33 Primary intraosseous meningioma
- Case 34 Suprasellar meningioma
- Case 35 Pituitary macroadenoma
- Case 36 Brain abscess
- Case 37 Neurocysticercosis
- Case 38 Tuberculosis
- Case 39 Creutzfeldt–Jakob disease
- Case 40 Herpes encephalitis
- Case 41 Wernicke’s encephalopathy
- Case 42 Hypertrophic olivary degeneration
- Case 43 Adrenoleukodystrophy
- Case 44 Mild traumatic brain injury
- Case 45 Isodense subdural hematoma
- Case 46 Posterior reversible encephalopathy syndrome
- Case 47 Late-onset adult hydrocephalus secondary to aqueductal stenosis
- Case 48 Intracranial hypotension
- Case 49 Idiopathic intracranial hypertension
- Case 50 Rathke’s cleft cyst
- Case 51 FLAIR sulcal hyperintensity secondary to general anesthesia
- Case 52 Virchow–Robin spaces
- Case 53 Arachnoid granulations
- Case 54 Benign external hydrocephalus
- Case 55 Pitfalls in CTA
- Case 56 Asymmetric pneumatization of the anterior clinoid process
- Case 57 Fibrous dysplasia of skull base
- Case 58 Sphenoid bone pseudolesion
- Case 59 Clival lesions
- Case 60 Perineural spread
- Case 61 Cochlear dysplasia
- Case 62 Labyrinthitis ossificans
- Case 63 Superior semicircular canal dehiscence
- Case 64 Fluid entrapment in the petrous apex cells
- Case 65 Acquired cholesteatoma
- Case 66 Malignant otitis externa
- Case 67 Temporal bone fractures
- Case 68 Allergic fungal sinusitis
- Case 69 Invasive fungal sinusitis
- Case 70 Spontaneous CSF leaks and sphenoid cephaloceles
- Case 71 Juvenile nasal angiofibroma
- Case 72 Idiopathic orbital pseudotumor
- Case 73 Optic neuritis
- Case 74 Intraparotid lymph nodes
- Case 75 Benign mixed tumor
- Case 76 First branchial cleft cyst
- Case 77 Nasopharyngeal cysts
- Case 78 Cystic nodal metastasis
- Case 79 Low-flow vascular malformations
- Case 80 Parapharyngeal masses
- Case 81 Third branchial apparatus anomaly
- Case 82 Parathyroid adenoma
- Case 83 String sign
- Case 84 Carotid artery dissection
- Case 85 Traumatic arterial injury
- Case 86 Craniovertebral junction injuries
- Case 87 Odontoid fractures
- Case 88 Vertebral compression fractures
- Case 89 Sacral insufficiency fracture
- Case 90 Paget’s disease of the spine
- Case 91 Renal osteodystrophy
- Case 92 Calcific tendinitis of the longus colli
- Case 93 T2 hyperintense disc herniation
- Case 94 Disc herniation and cord compression
- Case 95 Postoperative disc herniation versus postsurgical scarring
- Case 96 Degenerative endplate alterations
- Case 97 Spinal dysraphism
- Case 98 Tethered spinal cord
- Case 99 Chiari I malformation
- Case 100 Spinal vascular malformations
- Case 101 Cord compression
- Case 102 Demyelinating/inflammatory spinal cord lesion
- Case 103 Subacute combined degeneration
- Case 104 Intradural cyst
- Case 105 Spinal CSF leaks
- Case 106 Leptomeningeal drop metastases
- Index
- References
Case 30 - Pineal region tumors
Published online by Cambridge University Press: 18 December 2013
- Frontmatter
- Dedication
- Contents
- Preface
- Case 1 Dense basilar artery sign
- Case 2 Global anoxic brain injury
- Case 3 Acute infarction
- Case 4 Vertebral artery dissection
- Case 5 Subacute infarct
- Case 6 Subarachnoid hemorrhage
- Case 7 Intracranial aneurysms
- Case 8 Giant aneurysms
- Case 9 Acute intracerebral hematoma
- Case 10 Cerebral amyloid angiopathy
- Case 11 Primary CNS vasculitis
- Case 12 Reversible cerebral vasoconstriction syndrome
- Case 13 Moyamoya disease/syndrome
- Case 14 Cortical venous thrombosis
- Case 15 Developmental venous anomalies
- Case 16 Dural arteriovenous fistula
- Case 17 Cavernous malformation
- Case 18 Tumefactive demyelinating lesion
- Case 19 Acute disseminated encephalomyelitis
- Case 20 Progressive multifocal leukoencephalopathy
- Case 21 Osmotic myelinolysis
- Case 22 Neurosarcoidosis
- Case 23 Posterior fossa masses in children
- Case 24 Low-grade glioma
- Case 25 Diffuse intrinsic pontine glioma
- Case 26 Pseudoprogression of GBM
- Case 27 Pseudoresponse in treatment of GBM
- Case 28 Low-grade oligodendroglioma
- Case 29 Primary CNS lymphoma
- Case 30 Pineal region tumors
- Case 31 Intraventricular masses
- Case 32 Colloid cyst
- Case 33 Primary intraosseous meningioma
- Case 34 Suprasellar meningioma
- Case 35 Pituitary macroadenoma
- Case 36 Brain abscess
- Case 37 Neurocysticercosis
- Case 38 Tuberculosis
- Case 39 Creutzfeldt–Jakob disease
- Case 40 Herpes encephalitis
- Case 41 Wernicke’s encephalopathy
- Case 42 Hypertrophic olivary degeneration
- Case 43 Adrenoleukodystrophy
- Case 44 Mild traumatic brain injury
- Case 45 Isodense subdural hematoma
- Case 46 Posterior reversible encephalopathy syndrome
- Case 47 Late-onset adult hydrocephalus secondary to aqueductal stenosis
- Case 48 Intracranial hypotension
- Case 49 Idiopathic intracranial hypertension
- Case 50 Rathke’s cleft cyst
- Case 51 FLAIR sulcal hyperintensity secondary to general anesthesia
- Case 52 Virchow–Robin spaces
- Case 53 Arachnoid granulations
- Case 54 Benign external hydrocephalus
- Case 55 Pitfalls in CTA
- Case 56 Asymmetric pneumatization of the anterior clinoid process
- Case 57 Fibrous dysplasia of skull base
- Case 58 Sphenoid bone pseudolesion
- Case 59 Clival lesions
- Case 60 Perineural spread
- Case 61 Cochlear dysplasia
- Case 62 Labyrinthitis ossificans
- Case 63 Superior semicircular canal dehiscence
- Case 64 Fluid entrapment in the petrous apex cells
- Case 65 Acquired cholesteatoma
- Case 66 Malignant otitis externa
- Case 67 Temporal bone fractures
- Case 68 Allergic fungal sinusitis
- Case 69 Invasive fungal sinusitis
- Case 70 Spontaneous CSF leaks and sphenoid cephaloceles
- Case 71 Juvenile nasal angiofibroma
- Case 72 Idiopathic orbital pseudotumor
- Case 73 Optic neuritis
- Case 74 Intraparotid lymph nodes
- Case 75 Benign mixed tumor
- Case 76 First branchial cleft cyst
- Case 77 Nasopharyngeal cysts
- Case 78 Cystic nodal metastasis
- Case 79 Low-flow vascular malformations
- Case 80 Parapharyngeal masses
- Case 81 Third branchial apparatus anomaly
- Case 82 Parathyroid adenoma
- Case 83 String sign
- Case 84 Carotid artery dissection
- Case 85 Traumatic arterial injury
- Case 86 Craniovertebral junction injuries
- Case 87 Odontoid fractures
- Case 88 Vertebral compression fractures
- Case 89 Sacral insufficiency fracture
- Case 90 Paget’s disease of the spine
- Case 91 Renal osteodystrophy
- Case 92 Calcific tendinitis of the longus colli
- Case 93 T2 hyperintense disc herniation
- Case 94 Disc herniation and cord compression
- Case 95 Postoperative disc herniation versus postsurgical scarring
- Case 96 Degenerative endplate alterations
- Case 97 Spinal dysraphism
- Case 98 Tethered spinal cord
- Case 99 Chiari I malformation
- Case 100 Spinal vascular malformations
- Case 101 Cord compression
- Case 102 Demyelinating/inflammatory spinal cord lesion
- Case 103 Subacute combined degeneration
- Case 104 Intradural cyst
- Case 105 Spinal CSF leaks
- Case 106 Leptomeningeal drop metastases
- Index
- References
Summary
Imaging description
The pineal gland develops as a diverticulum in the roof of the third ventricle between 4 and 8 weeks of gestational age. However, it is not redundant, like an appendix, and secretes melatonin, which controls diurnal rhythm [1]. Normally, it has a pinecone-like shape, measures about 8–10mm, and does not have a blood–brain barrier, enhancing normally on post-contrast imaging. Histologically, lobules of pineocytes, which are specialized neurons, and a small amount of astrocytes, along with fibrovascular stroma, make up the normal gland.
Mass lesions of the pineal region make up less than 1% of intracranial masses in adults. However, in the pediatric age group they account for about 3–8% of intracranial neoplasms [2]. Tumors of pineal parenchymal origin account for about 14–27% of pineal masses [3] and include low-grade pineocytoma (Fig. 30.1), intermediate-grade pineal parenchymal tumor of intermediate differentiation (PPTID) (Fig. 30.2), and highly malignant pineoblastoma (Fig. 30.3).
Pineocytomas are more commonly found in adults, with an excellent (85–100%) 5-year survival rate following gross total resection. PPTID is a WHO grade II/III neoplasm that exhibits slight female preponderance, makes up at least 20% of all the pineal parenchymal tumors, peaks in early adulthood, and has a 5-year survival of 40–74% [4].
- Type
- Chapter
- Information
- Pearls and Pitfalls in Head and Neck and NeuroimagingVariants and Other Difficult Diagnoses, pp. 125 - 139Publisher: Cambridge University PressPrint publication year: 2013