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This axial (cross-sectional), contrast-enhanced T1-weighted MR image of the brain shows an enhancing (looks white) mass in and around the pineal gland which extends into the posterior third ventricle and obstructs the adjacent aqueduct of sylvius resulting in obstructive hydrocephalus. This represents a pineal gland germinoma which is the most common pineal tumor accounting for approximately 60% of pineal gland neoplasms. They are much more common in men than women.