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Case #22

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Demographics: 65 years old, Female
Indication: Confusion

Case #22

Findings

CT

MRI

  • Pineal region mass measuring 3.3 x 2.5 x 2.5 cm
  • Diffuse intermediate T2 signal, restricted diffusion, and avid enhancement
  • Peripheral foci of susceptibility artifact corresponding to calcification on the CT
  • Downward mass effect on the tectum with obstructive hydrocephalus at the level of the cerebral aqueduct and subependymal edema

Annotated Images & Illustrations

A pineal region mass with peripheral calcification (red arrow) is identified on CT.

A pineal region mass with peripheral calcification (red arrow) is identified on CT.

The mass demonstrates intermediate T2 signal intensity (red arrow). There is associated obstructive hydrocephalus with subependymal edema (yellow arrows).

The mass demonstrates intermediate T2 signal intensity (red arrow). There is associated obstructive hydrocephalus with subependymal edema (yellow arrows).

There is avid corresponding enhancement (red arrow).

There is avid corresponding enhancement (red arrow).

Diagnosis

Pineal parenchymal tumor of intermediate differentiation (PPTID)

Key Imaging Features

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Differential Diagnosis

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Discussion

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Pearls

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