Treatment of pineal cysts is as follows. For asymptomatic pineal cysts less than 2 cm in diameter and with typical presentation, clinical follow-up and annual imaging is performed. For lesions that cause clinical symptoms or changes in MRI performance, surgery is recommended to relieve symptoms and clarify the diagnosis. Surgical options for patients with hydrocephalus: 1. cerebrospinal fluid shunt. 2. resection. 3. stereotactic and endoscopic aspiration. 4. endoscopic third ventriculostomy. Some cases have been reported in the literature with regression of pineal cysts after treatment.