Is the location of the pineal calcification helpful in suggesting the diagnosis of a germ cell tumour?
Yes. Pineal parenchymal tumours (pineocytomas -> pineaoblastomas) tend to scatter calcifications to their periphery, whereas germ cell tumours tend to engulf them.
What is the most common type of germ cell tumour?
Germinomas account for 60-80% of all cases of intracranial germ cell tumour.
An EVD has been placed and the size of the ventricles has reduced. A subdural collection has developed, which is blood stained. The masses seen on CT are more easily seen on MRI. They are heterogeneous with prominent variegated enhancement, and a moderate amount of oedema extending into the adjacent parenchyma, particularly the brain stem.
On gradient echo imaging the pineal calcification is confirmed to be placed centrally within the mass (engulfed).