Pineal gland masses

INTRODUCTION

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 "Pediatric intracranial germ cell tumors".)

EPIDEMIOLOGY

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 [3-5]. 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.

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