Roentgen Diagnosis of Lipoma of the Corpus Callosum

Abstract

Lipoma of the corpus callosum is a rare intracranial tumor. Rokitansky (1) first called attention to this lesion in 1856. In 1946 List, Holt, and Everett (2) reported 2 cases and found 28 others in the world literature. A case published by Merkel (3) and one seen by Sosman (reported by Dyke, 4) were not included in their review. Sosman (6) has seen, but not reported, 4 other intracranial lipomas, 3 of which were in the mid-line. A further case has been recorded by Amyot (5). The addition of our case brings the total number of reported lipomas of the corpus callosum to 34. Since 37 of approximately 110 verified intracranial lipomas have involved the corpus callosum, it is evident that this structure is a common location for this rather rare intracranial tumor. Case Report A 30-month-old white boy was first seen at the Cleveland Clinic on June 15, 1947. He was born on Dec. 30, 1944, following an eight-month pregnancy and seven hours of labor. No instruments were used. The child was apparently well until the age of six weeks, when generalized convulsions occurred, lasting fifteen to twenty minutes. Following the convulsions he appeared drowsy. Similar episodes recurred on an average of once a day until the child was nine months old. He then had attacks during which he displayed a “crooked smile” and had left facial weakness, followed by flexion and twitching movements of both arms. These episodes lasted for a little over a minute, and were not associated with loss of consciousness, loss of sphincter control, or vomiting. The attacks frequently occurred in the early morning or when the child was excited. He occasionally vomited after meals, but vomiting had been infrequent since August 1946. Monosyllabic speech began at fifteen months, and walking was not well established until the age of two. The family history was non-contributory. The father, mother, and one older sister were alive and well. The boy appeared undernourished and underdeveloped, weighing 26 pounds. His arm and chest muscles were poorly developed. Ophthalmoscopic examination was negative. Neurologic examination revealed normal movements of the extremities. The pupils were round, equal in size, and reacted to light. Biceps and patellar reflexes were present and equal bilaterally. Triceps and Achilles reflexes were bilaterally absent. No pathologic reflexes or signs were noted. No motor disturbances were present, and, as far as could be ascertained, no sensory disturbances. The gait was wide-based, with some tendency to veer to the left. Skull roentgenograms obtained on June 15, 1947 (Fig. 1), revealed a radiolucent area, measuring 2.5 × 4 × 3 cm., slightly above and anterior to the mid-point of the cranial vault. This area was best demonstrated on the lateral film, on which it appeared as roughly oval in shape, with a concave inferior margin.