Findings:
A cystic pineal gland lesion is seen measuring 12 x 14.5 x 12 mm. The tectal plate is somewhat distorted but there is no evidence of obstructive hydrocephalus. The cyst does not have any solid component and only demonstrates a thin rim of enhancement.
The remainder of the brain is within normal limits, with no intra or extraaxial collection masses or focal regions of abnormal contrast enhancement noted.
The pituitary gland is normal.
The orbits, paranasal sinuses and mastoid air cells are clear.
No bony abnormality is seen. The craniocervical junction is normal.
Conclusion:
Cystic pineal gland lesion as described most likely represents a benign pineal cyst. Given its size, follow-up is recommended, as a cystic pineocytoma could have similar appearances.