Tumors of the pineal region are rare but pose interesting diagnostic a
nd therapeutic challenges. A diverse group of neoplasms may occur in t
he pineal region, and correct histologic diagnosis is critical to prop
er management of the disease. To emphasize the need for tissue diagnos
is, we present five cases of pineal region tumors, including germinoma
, pinealoblastoma, pinealoma, astrocytoma, and meningioma. In addition
, we discuss the differential diagnosis of pineal region tumors, empha
sizing the histologic, prognostic, and therapeutic differences between
various tumor types.