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AJR Teaching File: Solid Masses of the Pineal Region

Kevin P. Banks1 and Stephen J. Brown1

1 Both authors: United States Army, MCHE-DR, 3851 Roger Brooke Dr., Fort Sam Houston, TX 78234.


Figure 1
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  		Fig. 1A —19-year-old man presents with headaches and visual disturbances. Physical examination reveals double vision, vertical gaze paralysis, and light-near dissociation. Unenhanced CT images of head show well-defined hyperdense mass arising in pineal region. Large dense calcification is seen in inferior portion with two adjacent smaller calcifications. Surrounding brain parenchyma shows mild edema. Obstructive hydrocephalus is present.

 

Figure 2
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  		Fig. 1B —19-year-old man presents with headaches and visual disturbances. Physical examination reveals double vision, vertical gaze paralysis, and light-near dissociation. Sagittal T1-weighted MR image shows mass to be isointense to gray matter.

 

Figure 3
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  		Fig. 1C —19-year-old man presents with headaches and visual disturbances. Physical examination reveals double vision, vertical gaze paralysis, and light-near dissociation. Axial T2-weighted MR image shows isointense signal intensity to gray matter. Surrounding increased signal intensity verifies presence of localized edema.

 

Figure 4
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  		Fig. 1D —19-year-old man presents with headaches and visual disturbances. Physical examination reveals double vision, vertical gaze paralysis, and light-near dissociation. Postcontrast T1-weighted coronal MR image shows avid uniform enhancement of mass.

 

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