Case 092

History/Physical

History/Physical:

40-year-old right-handed female.

Generalized headache and diplopia for one month.

Heterogeneous mass in the pineal region (*).

Enhancement is hetergeneous. The normal pineal gland is obscured. The Sylvian aqueduct is compressed.

The mass causes hydrocephalus. The third ventricle is enlarged (arrow).

The lateral ventricle atria are enlarged (*). There is transpendymal CSF flow (arrows).

High signal on diffusion suggests this mass is hypercellular.

Diagnosis: Pineocytoma

Hypercellular but monotonous lesion with rosette formation and delicate vasculature.

Rosettes (*) and finely stippled neuroendocrine nuclei.

Synaptophysin expression.

Neurofilament expression.