Demographics:
7 years old, Male
Indication:
Altered mental status
Findings
CT
- Irregular, heterogeneous pineal region mass with associated calcification and internal hypoattenuating areas
- Associated mass effect on the cerebral aqueduct with obstructive hydrocephalus and subependymal edema about the third and lateral ventricles
MRI
- Heterogeneous pineal region mass measuring 2.4 x 2.3 x 2.3 cm which bulges into the posterior aspect of the third ventricle and exerts downward mass effect on the tectum with obstruction of the cerebral aqueduct
- Patchy internal areas of restricted diffusion and enhancement
- Susceptibility artifact corresponding with the areas of calcification on CT
- Additional site of abnormal soft tissue centered in the chiasmatic and infundibular recesses of the third ventricle, which may represent a separate tumor or intraventricular tumor spread
- Obstructive hydrocephalus involving the lateral and third ventricles with subependymal edema
Annotated Images & Illustrations
Dominant mass in the pineal region (red arrow) with a smaller mass anteriorly centered in the anterior recesses of the third ventricle (yellow arrow).
Diagnosis
Teratoma (pineal region)
Differential Diagnosis
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Pearls
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