T1 sagittal post gad T1 axial post gad T1 coronal post gad

Diagnosis: Suprasellar/sellar germinoma and pineal teratoma

The combination of a pineal and sellar/suprasellar mass strongly suggests the diagnosis of a germ cell neoplasm. A pineal parenchymal tumor such as a pineocytoma or pineoblastoma does not typically spread to the sellar and suprasellar region. They may however, seed the CSF. Germinoma is a pineal germ cell neoplasm which makes up almost 1/2 of pineal neoplasms. Patients are typically young men between the ages of 10 and 30. Most occur in the pineal and suprasellar regions. They may show heterogeneous signal on MR and usually demonstrate homogeneous enhancement. Germinomas often spread via the ependymal lining.

Teratoma is the second most common germ cell neoplasm. These tumors also have a strong male predominance and are seen in children. They may contain elements of ectoderm, mesoderm, or endoderm and may contain calcification or fat. Choriocarcinoma is another germ cell neoplasm which is much less common than either germinoma or teratoma and has a non-specific radiographic appearance. Related Cases

Pituitary adenoma Lung cancer metastases Germinoma/Teratoma