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Genetic and Rare Diseases Information Center (GARD)

Pineal cyst


* Not a rare disease

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Your Question

Can you please send me any information you have concerning symptomatic pineal cyst? I greatly appreciate your help.

Our Answer

We have identified the following information that we hope you find helpful. If you still have questions, please contact us.

What are pineal cysts?

Pineal cysts are cysts of the pineal gland which is a small organ in the brain that produces melatonin (a sleep-regulating hormone). Pineal cysts are relatively common and may be found by chance in up to 10% of people undergoing CT or MRI brain imaging. The exact cause of pineal cysts is unknown. Most people with pineal cysts do not have any signs or symptoms.[1] Rarely, a pineal cyst may cause headaches, hydrocephalus, eye movement abnormalities, and Parinaud syndrome.[2] Treatment is usually only considered when a cyst is causing symptoms, in which case surgery, stereotactic aspiration or endoscopic treatment may be recommended.[3][4]
Last updated: 11/13/2014

What are the signs and symptoms of pineal cysts?

People with pineal cysts generally do not have any signs or symptoms. Occasionally, pineal cysts may cause headaches, hydrocephalus, disturbances in vision (gaze palsy), Parinaud syndrome, and vertigo, in which case they are called symptomatic pineal cysts.[5] Although rare, people with symptomatic pineal cysts may have other symptoms such as difficulty moving (ataxia); mental and emotional disturbances; seizures; sleep (circadian rhythm) troubles; hormonal imbalances that may cause precocious puberty; or secondary parkinsonism.[5]
Last updated: 11/13/2014

Is there a correlation between pineal cyst size and symptoms?

No. In most cases, there does not seem to be a relationship between cyst size and the onset of symptoms. While asymptomatic pineal cysts are usually less than 10 mm in diameter, symptomatic pineal cysts vary in size from 7 mm to 45 mm.[5] One study of 151 individuals with asymtomatic pineal cysts found that half of the pineal cysts were smaller than 10mm and half were larger than 10mm in greatest dimension.[6]
Last updated: 11/13/2014

Are there any factors such as sex or age that influence the presence of or growth of pineal cyst?

People of all ages can develop pineal cysts, although an increased prevalence is observed in older patients. The prevalence of the pineal cysts also appears to be slightly greater in women than men. Some have proposed that hormonal factors may account for the increased prevalence in women.[7]
Last updated: 11/13/2014

What causes pineal cysts?

The exact cause of pineal cysts is unknown. However, some studies suggest that bleeding in the pineal region or hormonal influences may play a role in the development and progression of pineal cysts.[5][8]
Last updated: 11/13/2014

How might pineal cysts be treated?

The best treatment options for pineal cysts depend on many factors, including the size of the cyst and whether or not it is associated with symptoms. For example, people with pineal cysts that do not cause symptoms may not require any form of treatment.[9] However, they may need to have regular check-ups with a physician and follow up imaging if they have a large cyst (greater than 10-14 mm) or develop symptoms that could be related to the cyst.[9]

Treatment is often recommended for those individuals with pineal cysts that cause hydrocephalus; neurological symptoms such as headache or disturbance of vision; or enlargement of the cyst over time.[10][2] 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.[3] Radiation therapy may be recommended for cysts that recur after treatment.[9]
Last updated: 3/27/2015

  • Fakhran S, Escott EJ. Pineocytoma mimicking a pineal cyst on imaging: true diagnostic dilemma or a case of incomplete imaging?. American Journal of Neuroradiology. 2008; 29:159-163. Accessed 12/13/2011.
  • Al-Holou WN, Maher CO, Muraszko KM, Garton HJL. The natural history of pineal cysts in children and young adults. J. Neurosurg. Pediatrics. February 2010; 5(2):162-166.
  • 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.
  • 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.
  • Bosnjak J, Budisic M, Azman D, Strineka M, Crnjakovic M, Demarin V. Pineal gland cysts--an overview. Acta Clin Croat. September 2009; 48(3):355-358.
  • 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.
  • Wajd NA, Garton HJL, Muraszko KM, Ibrahim M, Maher CO. Prevalence of pineal cysts in children and young adults. J. Neurosurg. Pediatrics. 2009;
  • Pineal Cysts, Symptomatic. NORD. October 2007; Accessed 11/13/2014.
  • Maria Moschovi, MD; George P Chrousos, MD. Pineal Gland Masses. UpToDate. October 2013;
  • Taraszewska A, Matyja E, Koszewki W, Zaczynski A, Bardadin K, Czernicki Z. Asymptomatic and symptomatic glial cysts of the pineal gland. Folia Neuropathol. 2008; 46(3):186-195.
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.