Sagittal T1 MRI without contrast of the brain (above left) shows an isointense lesion in the tectum and in the pineal gland which on sagittal FLAIR (above right) appears to shows low signal intensity representing perhaps calcification in its pineal component. The lesion is causing dilation of the third ventricle. Axial T2 MRI (below left) shows dilation of the lateral ventricles and transependymal flow of cerebral spinal fluid. Axial T1 MRI with contrast (below right) shows enhancement in the mass.
The diagnosis was tectal glioma that may also involve the pineal gland.
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