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Scans demonstrate two different pineal region extraaxial masses roughly following CSF intensity: hypointense on T1-weighted images and hyperintense on T2-weighted images.
Closer inspection demonstrates that the lesion in Case A has crenulated, irregular margins compared with the smoothly marginated contours of the lesion in Case B.
In addition, in Case A, the lesion is hyperintense compared with CSF on FLAIR and DWI. In contrast, the internal signal characteristics of the lesion in Case B are isointense compared with CSF on all sequences, including the FLAIR and DWI sequences.
Epidermoid cyst (bright on DWI)
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