Pineal Gland Cyst (Pineal Cyst)

A penial gland cyst is a sac of fluid located in a region of the brain where the pineal gland is resting. Penial gland cysts are usually found in women who are 20-30 years old. A pineal cyst does not cause any harm but is confused with other tumors very often and thus require proper diagnosis.

Causes

The causes behind the development of pineal gland cysts are still not found.

Pineal Gland Cyst Types

There are two types of pineal cyst usually observed.

Small pineal cyst

Their occurrences are very common and are often found during neurological exams. These cysts hardly show any symptoms. Small pineal cysts measure 5 cm or smaller in certain cases.

Pineal Gland Cyst Photo Picture 1 – Pineal Gland Cyst

Large pineal cyst

These cysts are rarely found and are known to cause a lot of symptoms.

Symptoms

Pineal gland cyst usually does not show symptoms. However, if the pineal cyst size increases somewhere between 7 mm-45 mm, they might start showing symptoms. Large cysts increase pressure on the brain and give rise to some common symptoms.

The most common symptoms are:

  • Headache
  • Vomiting
  • Increased sensitivity to light
  • Nausea
  • Visual problems
  • Vertigo
  • Sleeping troubles
  • Tiredness
  • Lack of muscle coordination.

The symptoms which appear rarely are:

  • Ataxia
  • Emotional disturbances
  • Disruption of sensory and motor functions
  • Secondary parkinsonism
  • Epilepsy
  • Precocious puberty (hypothalamic dysfunction)
  • Loss of consciousness

Enlargement of the cyst results in a condition which is called ‘hydrocephalus.’  This condition develops when cerebral aqueduct faces an obstruction due to the continuous growth of the pineal cysts. As a result, pressure accumulates in the brain. This condition might get serious at times and lead to coma or death.

Diagnosis

Pineal gland cyst is diagnosed through CT scan and MRI scans.

MRI Scan

MRI scans help in differentiating pineal region from pineal germinoma, pineoblastoma and pinecytoma.

T1

  • Pineal cysts give a homogeneous signal.
  • 60 % of the cyst is hyper intense.
  • Iso to hypo intense in comparison to brain parenchyma.
  • Shows high signal
  • Mild hypo intense in comparison to CSF

T2

Sometimes when there is an enhancement of nodules, it becomes difficult to distinguish cystic pineocytoma from a pineal cyst based on imaging tests only. Also, there might be other additional tumors which might develop in the pineal region. These tumors might contain cystic elements which might prove fatal. Therefore it is necessary to conduct a differential diagnosis.

The differential diagnosis should be done for detecting the presence of the following:

  • Germ cell tumors
  • Epidermoid cyst
  • Teratoma
  • Arachnoid cyst
  • Embryonal carcinoma
  • Choriocarcinoma
  • Germinoma
  • Metastasis
  • Pineocytoma
  • Pineoblastoma

Treatment

Cysts in most cases are harmless. Treatment is required when the cysts start growing larger and symptoms start appearing. If symptoms get severe such as the occurrence of black outs and dizzy feeling, pineal gland cyst removal is to be done immediately. Pineal gland cyst surgery will involve removing the mass. No further treatment is needed after surgery since these lesions do not reappear. Those cases which do not require surgery can be controlled with medicines and will be put under strict observance to check their growth.

Prognosis

Studies have shown that only a few patients have developed enlarged cysts over the years. 75 % of the incidences show shrinking of the cyst or the size of the cyst remains the same. Cysts with certain distinctive features will be followed up clinically for a long time.

Reference:

  1. http://www.ncbi.nlm.nih.gov/pubmed/20055263
  2. http://www.webmd.com/brain/pineal-cysts-symptomatic
  3. http://radiopaedia.org/articles/pineal_cyst
  4. http://www.nervous-system-diseases.com/pineal-cyst.html

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