Female, 37 years old, with a pineal lesion noted on head CT, please evaluate further. A cystic pineal lesion is evident measuring up to 15 mm AP, 9 mm CC, and 12 mm TV. Incomplete and somewhat irregular enhancement of the rim of the lesion is seen, along with a central enhancing component which could represent a septation or perhaps a portion of the native pineal gland.The lesion appears to exert mild mass effect upon the underlying tectum of the midbrain. No significant parenchymal edema is seen though there may be very slight associated narrowing of the cerebral aqueduct.Brain parenchymal morphology is otherwise unremarkable. No significant edema or generalized mass effect is detected. No other enhancing lesions are observed. There are no findings to suggest intracranial hemorrhage. Ventricles are normal in size and morphology.
The presence of a cystic pineal lesion is confirmed on this examination measuring up to 15 mm in maximum dimension. The lesion is slightly complex as there is partial irregular wall enhancement, along with an enhancing central component which could, however, represent a portion of the native pituitary gland. Statistically, this lesion most likely represents a benign pineal cyst, with a neoplastic etiology such as a pineocytoma considered less likely. A follow-up examination is recommended in 6-12 months to verify stability of the lesion.