Pineal gland metastases
Pineal gland metastasis is a rare site of metastatic disease. They usually occur concomitantly with leptomeningeal metastases.
This article will discuss metastatic lesions affecting only the pineal gland. For other intracranial metastatic locations, please refer to the main article on intracranial metastases.
Epidemiology
The real incidence of pineal metastasis is not clear, studies have reported a prevalence of 0.4 to 3.8% in patients with metastatic solid tumors .
Clinical presentation
Pineal metastases are usually asymptomatic unless a certain volume is reached, then causing a local mass effect that may manifest as a Parinaud syndrome or increased intracranial pressure symptoms related to obstructive hydrocephalus .
Pathology
Pineal gland metastases are mostly due to spread of primary carcinomas of the :
- lung
- breast
- gastrointestinal tract
- kidneys
- bladder
- pancreas
- ovary
- testis
Differential diagnosis
All the masses that may affect the pineal region are considered among the differential diagnosis. There are no specific imaging features for a metastasis to the pineal gland itself, with the clinical history and the concomitant leptomeningeal carcinomatosis playing a more important role in this scenario.