case_images: PMC10601833_01
case_images: Axial non-contrasted brain CT showing a hyperdense well-defined pineal region mass extended to the posterior third ventricle with a central calcification.
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case_images: F1
case_images: Brain computed tomography (CT) demonstrated a large mass located in the pineal region, resulting in obstructive hydrocephalus (Fig. 1).
case_images: MRI brain; a T1-WI demonstrating a pineal region lesion (I: sagittal, II: axial, III: coronal) that after gadolinium administration showing as a well-defined and circumscribed vividly enhancing mass engulfing the pineal gland, causing narrowing of the cerebral aqueduct and causing mild ventricular dilatation without transependymal permeation, mass effect on the thalamus, midbrain, pons, and effacing the ambient and quadrigeminal cisterns. b T2-WI showing a well-defined and circumscribed isointense lesion engulfing the pineal gland (I: axial, II: coronal), causing narrowing of the cerebral aqueduct and causing mild ventricular dilatation without transependymal permeation, mass effect on the thalamus, midbrain, pons, and effacing the ambient and quadrigeminal cisterns. MRI, magnetic resonance imaging.
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case_images: F2
case_images: Additionally, another smaller lesion was noted in the genu of the corpus callosum and septum pellucidum, measuring 2.5 x 1.4 x 1.7 cm (Fig. 2a-c).
case_images: The figure shows H&E staining at low (a) and intermediate (b) power, revealing large epithelioid cells with abundant cytoplasm, round nuclei, irregular and pleomorphic nuclei, and prominent nests of lymphocytes. Immunohistochemical staining demonstrates strong and diffuse nuclear staining for OCT4 (c) and positive diffuse cytoplasmic staining for CD117/C-KIT (d). H&E, hematoxylin and eosin.
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case_images: F3
case_images: The conclusion was a germ cell tumor with features and an immunoprofile consistent with germinoma (Fig. 3a-d).
case_images: Postoperative non-contrasted brain CT, showing expected postoperative changes.
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case_images: F4
case_images: A postoperative brain CT showed a subtotal resection along with postoperative changes with no complications (Fig. 4a-b).