Figure 5. Metachronous hypothalamic and pineal gland germinomas in a 3-year-old girl with central DI. Sagittal contrast-enhanced T1-weighted MR image shows a well-defined, lobulated, homogeneously enhancing mass (germinoma) involving the proximal part of the infundibular stalk (straight arrow) and the base of the hypothalamus (arrowheads). An associated pineal gland germinoma (curved arrow) is also seen. The diagnosis was confirmed at surgery.