Pineal cysts may be incidentally noted on MRI brain. A pineal cyst is called “incidental” if it does not produce any symptoms or signs.
In a large series of >42,000 MRI brains, incidental pineal cysts were noted in 281 (0.67%) patients. About two-thirds of them were females. The mean size of incidental pineal cyst was 10 mm. MRI brain was repeated in 181 patients after a median follow up of 6 months. There was no change in size noted in 94% of patients. No patient developed any complications due to pineal cysts on follow up. (Ref: World Neurosurgery, 2016).
Our patient was a 45-year old man, in whom MRI brain was done for evaluation of headache. An incidental pineal cyst 9 mm in size was noted. He was advised to return for follow up after 6-12 months.
- Incidental pineal cysts on MRI brain is not uncommon and can be seen in 7 out of 1000 MRIs.
- Incidental pineal cysts are about 10 mm in size and do not produce any symptoms.
- Incidental pineal cysts follow a benign course and majority of them do not change in size over time.
- Patients with incidental pineal cysts on MRI brain may be followed up for one year and if the size does not increase for a year, they can be discharged from routine follow-up and surveillance.