There is a well-defined, lobulated, heterogeneously-enhancing mass seen in the pineal region. There is dilatation of the third ventricle with bulging of the infundibular and optic recesses. There is also mass effect on superior aspect of cerebellum.

The differential diagnosis for this mass includes:
1. Germinoma
2. Teratoma
3. Pineoblastoma / Pineocytoma
4. Astrocytoma of pineal gland
5. Metastasis
Reference: JG Smirniotopoulos, EJ Rushing, and H Mena. Pineal region masses: differential diagnosis. RadioGraphics 1992; 12: 577.
Credit: Dr Abhijit Datir