Pineal gland cyst
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
A pineal gland cyst is a cyst in the pineal gland, a small endocrine gland in the brain.. Statisically, these fluid-filled bodies appear on 1-4% of magnetic resonance imaging (MRI) brain scans. They are more frequent at death, seen in 21-41% of autopsies, though researchers are not sure why. They are in most cases asymptomatic, and it is rare for a pineal cyst to cause symptoms. If they do, these would most likely be headache, visual disturbances, or hydrocephalus, which can be extremely dangerous if left untreated. Pineal cysts are not cancer and most of the time they do not enlarge over 2 centimeters.
Asymptomatic cysts require no treatment. Some doctors choose to monitor patients with CT scans or MRI to look for cyst growth, but most doctors do not.
Differentiating Pineal gland cyst from Other Diseases
- Pineal cysts are most often mistaken for and may be indistinguishable from a benign pineocytoma. Pineocytomas are more likely to have solid components.
- Other cysts in the quadrigeminal cistern that mimic pineal cysts include arachnoid cysts and, rarely, epidermoids.
Diagnosis
- Attenuation or signal intensity varies with cyst content.
- One-fourth have rim or nodular calcium in the cyst wall on nonenhanced CT scans.
- Rim or nodular enhancement is also common.
- On T1-weighted MR images, 55%–60% are slightly hyperintense to CSF. Most do not appear hypointense on FLAIR images, and 60% enhance with use of contrast material.
