• Amber A Retzlaff, Karen Arispe, Elizabeth J Cochran, and Nathan T Zwagerman.
• Department of Radiation Oncology, Froedtert and the Medical College of Wisconsin, Milwaukee, Wisconsin, USA. Electronic address: aretzlaff@mcw.edu.
• World Neurosurg. 2020 Jan 1; 133: 308-313.

BackgroundIntravascular papillary endothelial hyperplasia (IPEH) is a benign vascular lesion that is uncommon in the central nervous system. To our knowledge, there has been only one previous report of occurrence in the pineal region. We present a second case and a review of the literature.Case DescriptionA 28-year-old woman presented with 1 month of headaches and visual auras. Brain magnetic resonance imaging scan demonstrated a 2.6- × 1.8- × 1.3-cm nonenhancing T1-hypointense, T2-/fluid-attenuated inversion recovery-hyperintense pineal region mass with cerebral aqueduct obstruction and hydrocephalus. She underwent placement of a right extraventricular drain followed by complete surgical resection. Histologic analysis was consistent with IPEH.ConclusionsAlthough rare, IPEH is an entity that should be considered in the differential diagnosis for intracranial masses with radiographic features characteristic of vascular lesions. Tissue sampling is imperative for distinction from more malignant entities. Complete resection is curative and is the standard of care when feasible. Given the risk of local progression and neurologic compromise with subtotal resection of central nervous system lesions, further study regarding adjuvant treatment options is warranted.Copyright © 2019 Elsevier Inc. All rights reserved.

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