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Pineal gland masses

Maria Moschovi, MD
George P Chrousos, MD
Section Editors
Jay S Loeffler, MD
Patrick Y Wen, MD
Amar Gajjar, MD
Deputy Editor
April F Eichler, MD, MPH


Tumors involving the pineal gland or body are uncommon (figure 1). The classification, presentation, and general approach to lesions involving the pineal gland will be presented here, focusing on the management of pineal parenchymal tumors.

Germ cell tumors, the most frequent tumor type found in the pineal region, are discussed elsewhere. (See "Intracranial germ cell tumors".)


In Europe and North America, pineal tumors account for less than 1 percent of all primary brain tumors [1]. Pineal tumors are more common in children aged 1 to 12 years where these constitute about 3 percent of brain tumors [2].

Pineal tumors are more common in Asian countries than in Western countries [3,4]. This increased frequency is due largely to an increase in germ cell tumors, which comprise 70 to 80 percent of all pineal region tumors in Japan and Korea. In one study, there was a significantly higher incidence of intracranial germ cell tumors in Asian/Pacific Islanders living in the United States compared with whites in the 10 to 29 year age group, suggesting that underlying genetic susceptibility may play a role in the etiology of these tumors [5].

Pineal tumors are substantially more common in males. In an analysis of 633 cases from the Surveillance, Epidemiology and End Results (SEER) database over a 32 year period, pineal tumors were three times more common in males than females [1]. In those with germ cell tumors, the male predominance was approximately 12:1.


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