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Genetic and Rare Diseases Information Center (GARD)

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Pineal cyst


* Not a rare disease

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How might a pineal cyst be managed if it does not cause symptoms?

There is limited information about what happens to a pineal cyst over time.  Several studies have shown that most pineal cysts remain stable and do not increase in size or cause symptoms later in life.[1][2]  One study found that larger cysts were more likely to decrease in size over time[1], and there is currently no evidence that larger cysts are more likely to cause symptoms.[2]  

Because guidelines for management depend on an understanding of the typical course of a condition, and currently there is limited information about pineal cysts, there is some debate about the most appropriate way to manage these cysts.[3]  Some studies do not recommend repeated magnetic resonance imaging (MRI) of the cyst.[3]  Other studies state that repeated imaging of a pineal cyst is not required.[1]  Another approach is for individuals with a pineal cyst to have regular check-ups with their personal doctor; if at any point new symptoms arise that may be related to the pineal cyst, repeat imaging should be done.[3][2]
Last updated: 8/18/2014

How might symptomatic pineal cysts be treated?

Whether patients with symptomatic pineal cysts should be monitored and/or treated is still unclear.  However, surgery is usually recommended for those individuals with pineal cysts that cause hydrocephalus, worsening neurological symptoms such as headache or disturbance of vision, or enlargement of the cyst over time.[4][5]  Treatment may include surgery to remove the cyst, sometimes followed by the placement of a ventriculoperitoneal shunt.  Aspiration of the contents of the cyst using ultrasound guidance has been explored as an alternative approach to surgery, and more recently, endoscopic procedures have been used.[6]
Last updated: 12/29/2011

  1. Al-Holou WN, Terman SW, Kilburg C, Garton HJ, Muraszko KM, Chandler WF, Ibrahim M, Maher CO.. Prevalence and natural history of pineal cysts in adults. Journal of Neurosurgery. December, 2011; 115(6):1106-1114. Accessed 12/31/2013.
  2. Barboriak DP, Lee L, Provenzale JM. Serial MR imaging of pineal cysts: implications for natural history and follow-up. Am J Roentgenol. 2001; 176:737-743. Accessed 12/31/2013.
  3. Gaillard F, Jones J. Masses of the pineal region: clinical presentation and radiographic features. Postgraduate Medical Journal. 2010; 86:597-607. Accessed 12/13/2011.
  4. Taraszewska A, Matyja E, Koszewki W, Zaczynski A, Bardadin K, Czernicki Z. Asymptomatic and symptomatic glial cysts of the pineal gland. Folia Neuropathol. 2008;
  5. Al-Holou WN, Maher CO, Muraszko KM, Garton HJL. The natural history of pineal cysts in children and young adults. J. Neurosurg. Pediatrics. 2010;
  6. Costa F, Fornari M, Valla P, Servello D. Symptomatic Pineal Cyst: Case Report and Review of the Literature. Minim. Invas. Neurosurg.. 2008; 51:231-233.

See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.