A 63-Year-Old Woman With a Pineal Mass

A 63-year-old woman (Karnofsky performance status 80) presented with a several-month history of shuffling gait, frontal headache, and urinary urgency. Magnetic resonance imaging of the brain demonstrated hydrocephalus secondary to a 2.7-cm, fairly well demarcated, enhancing mass in the pineal gland (Fig. 1). The patient underwent suboccipital craniotomy and gross total resection, with pathology demonstrating a pineal parenchymal tumor of intermediate differentiation (World Health Organization II vs III, favoring grade III) with MIB-1 index of 10% (1).

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