Distinguishing between Germinomas and Pineal Cell Tumors on MR Imaging

Abstract

BACKGROUND AND PURPOSE:Tumors of pineal cell origin have different prognosis and treatment than those of germ cell origin. The recent literature suggests that these tumors often look alike. Our study aimed to differentiate between pineal cell tumor and germinoma based on ADC values, the homogeneity of the mass, and MR imaging characteristics.

Clinical, Pathological, and Surgical Outcomes for Adult Pineoblastomas

“…Germinomas, commonly in the differential diagnosis of pineal tumors, also have overlap in imaging appearance, but have been found to demonstrate less diffusion restriction (9). All but one of our patients presented with radiographic and clinical signs of hydrocephalus, including headache, double vision, blurry vision, and obtundation.…”

“…The imaging characteristics of pineoblastomas have been previously described (9,23,27,31). Pineoblastomas are often large (>3 cm) at presentation, and cause obstructive hydrocephalus in nearly all patients.…”

Primary extragonadal germinoma of the pineal gland: a case report

“…Germinomas are prone to disseminate through the CSF and hence MRI of the entire neuroaxis and lumbar puncture are mandatory to rule out CSF seedling and drop metastases. 8,9 Tissue biopsy is necessary for an accurate diagnosis due to the difference in treatment protocol for other histological subtypes. Germinomas are well circumscribed solid, soft and friable tumours with variable cystic component and calcification is a common feature.…”

Imagery of pineal tumors

“…Germinomas are the most common CNS germ cell tumor and the most frequent pineal mass [6,7]. Pure germinomas can occur mixed with a primitive germ component such as an endodermal sinus tumor, choriocarcinoma, or immature teratoma [8].…”