CT of pineal tumors and intracranial germ-cell tumors.

We reviewed 59 cases of pineal tumors and intracranial germ-cell tumors. Most pineal tumors occurred in the first three decades of life, with the exception of pineocytomas, which were seen at a mean age of 34. A male preponderance was noted in the various pineal tumors, except for pineocytomas. The most common tumor of the pineal region was germinoma, which usually showed high density with homogeneously intense enhancement after IV administration of contrast medium. An increased prevalence of pineal calcification was also a feature of pineal germinomas. No characteristic CT features could be found to differentiate among pineal choriocarcinoma, germinoma, embryonal carcinoma, yolk-sac tumor, pineocytoma, and pineoblastoma. CT is useful in detecting intracranial tumors, but the definite diagnosis should depend on pathologic examination and detection of tumor markers in the serum and CSF.