Tumors of the pineal region

The role played by neuroradiologic examinations in the diagnosis of neoformations of the pineal region is considered. Results of reports of literature are compared with the personal experience (40 patients) to draw possible significant conclusions for the diagnosis of the oncological type. First, intrinsic pineal lesions should be separated from those of adjacent structures. Reliable discriminating parameters useful in the differential diagnosis are represented by sex and age. Diagnosis based on biochemistry with markers was shown not to be univocal. A further separation can be based on CT and MRI findings. In particular, teratomas appear as solid tumors with calcification and fat. The latter is depicted on MRI even if minimal. To the contrary, germinomas do not contain fat and are markedly enhancing. Microcysts seem to be more common in tumors originating from parenchymal pineal cells. A reliable differential diagnosis is however possible only for small-sized lesions where identification of the anatomical structure of origin is easier.