Masses in the pineal region that may demonstrate intrinsic T1 hyperintensity can be following and can be excluded with routine MR imaging techniques. For example, a fat-saturated T1-weighted sequence may exclude a teratoma, dermoid, or lipoma as in our case. A partially thrombosed aneurysm or venous malformation with subacute blood products can be excluded with MR or CT angiography and absence of pulsation artifacts. A hemorrhagic metastasis from a renal, thyroid, or melanoma primary may be excluded by the lack of susceptibility effects on gradient-echo sequences. Melanotic melanomas will also demonstrate susceptibility effects. Also note intrinsic T1 hyperintensity may be a characteristic imaging appearance for a Papillary tumour of the pineal region. In the imaging absence of fat, hemorrhage, melanin, or calcification in a mass of the posterior commissure or pineal region, the diagnosis of a PTPR may be suggested. This is 50 year old female with headache. Differential of papillary tumour or malignant melanoma was suggested.
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