Intracranial Lipomas Research Articles

Lipoma of the Corpus Callosum: Report of a Case and Review of the Literature

Intracranial lipomas are exceptionally rare congenital lesions. This article presents a case of a 68-year-old female patient who experienced chronic headaches. Imaging studies revealed a fat-density formation in the anterior corpus callosum. While most corpus callosum lipomas are asymptomatic and typically found incidentally, they can be associated with congenital malformations, particularly affecting corpus callosum development. This case underscores the importance of imaging techniques, such as CT and MRI.

Anomalies of the Mesenchyme (Meninges and Skull)—Defects of Neural Tube Closure: Cephalocele and Other Calvarial and Skull Base Defects; Intracranial Lipomas; Arachnoid Cysts; Nonsyndromic and Syndromic Craniosynostoses

AbstractWithin the embryonic head, a layer of mesenchyme envelops the brain beneath the surface ectoderm. This cranial mesenchyme is responsible for the formation of the meninges, the calvaria (upper portion of the skull), and the scalp's dermis. Irregular development of these structures, particularly the meninges and the calvaria, is associated with notable congenital defects in humans, such as defects in neural tube closure. Anencephaly is the most common neural tube defect (NTD) and one of the most severe malformations of the central nervous system; it consists in the complete or partial absence of the brain, associated with the absence of the bones of the cranial vault. Iniencephaly is an uncommon congenital NTD characterized by abnormalities in the occipital region, including rachischisis of the cervicothoracic spine and a fixed retroflexion deformity of the head. Unlike anencephaly, in iniencephaly, there is a skull cavity and a normal-looking skin that entirely covers the head and the medullary retroflex area. Cephaloceles are congenital abnormalities distinguished by the protrusion of meninges and/or brain tissue through a naturally occurring defect in the skull bone. This anomaly is typically covered by skin or mucous membrane. Intracranial lipoma is a relatively uncommon and generally benign tumor that occurs in an abnormal location within the brain; it probably represents a disturbance of the differentiation of the primordial meninges: for unknown causes, the meningeal mesenchyme can differentiate into adipose tissue. Arachnoid cysts are sacs filled with cerebrospinal fluid (CSF) situated between the brain or spinal cord and the arachnoid membrane. Typically, these cysts originate within CSF cisterns and gradually expand their boundaries. Craniosynostosis is the early fusion of one or more cranial sutures. It can occur spontaneously, be associated with a syndrome, or have a familial connection. It can involve one or multiple cranial sutures. Pfeiffer's, Crouzon's, and Apert's syndromes are among the more prevalent syndromic craniosynostoses.

Encephalocraniocutaneous Lipomatosis: A Case Report.

Encephalocraniocutaneous lipomatosis (ECCL) is a rare congenital syndrome and subclassification of oculoectodermal syndrome. Encephalocraniocutaneous lipomatosis may be associated with postzygotic mutations. However, absence of an identifiable mutation does not preclude a diagnosis of ECCL. Encephalocraniocutaneous lipomatosis commonly causes skin, eye, and central nervous system anomalies. Diagnosis can be made through genetic sequencing or standardized clinical criteria. One clinically apparent major criterion for the diagnosis of ECCL is nevus psiloliparus (NP), a fatty nevus with overlying nonscarring alopecia. In this case, a 50-day-old female infant with uncomplicated birth history presented to dermatology clinic for evaluation of 2 superficial cranial masses that had been present since birth without regression or evolution. One of the masses was located within the hairline and demonstrated overlying nonscarring alopecia, suspicious of NP. Because of concern for ECCL, brain magnetic resonance imaging was ordered and revealed 2 intracranial lipomas. Genetic testing was inconclusive. Excision of the masses was performed at the request of the parents for cosmetic purposes. Histologic evaluation of the surgical specimens confirmed the diagnosis of NP and ECCL. A suspected NP should raise concern for ECCL and prompt further evaluation for systemic involvement. In particular, patients with suspected ECCL should be screened for ocular and CNS involvement. Early identification and diagnosis are important for prognostication because patients with ECCL are at increased risk of developing neoplasms of the head and neck and may require more frequent screening examinations.

A case of Wilson’s disease combined with intracranial lipoma and dysplasia of the corpus callosum with review of the literature

BackgroundWilson’s disease (WD) is an inherited disorder of copper metabolism. Agenesis of the corpus callosum is the complete or partial absence of the major united fiber bundles connecting the cerebral hemispheres. Intracranial lipoma is an adipose tissue tumor resulting from an abnormal embryonic development of the central nervous system. The simultaneous occurrence of these three disorders is rare and has not been reported. This report focuses on the pathogenesis and association between the three disorders and highlights the importance of recognizing and effectively managing their coexistence.Case presentationThe purpose of this study was to present a patient with coexisting WD, intracranial lipoma, and corpus callosum dysplasia. We reviewed a female patient hospitalized in 2023 with clinical manifestations of elevated aminotransferases and decreased ceruloplasmin, as well as genetic testing for an initial diagnosis of Wilson’s disease. Subsequently, a cranial MRI showed corpus callosum dysplasia with short T1 signal changes in the cerebral falx, leading to a final diagnosis of Wilson’s disease combined with intracranial lipoma and corpus callosum dysplasia. The patient’s WD is currently stable after treatment with sodium dimercaptosulfonamide (DMPS) and penicillamine, and the patient’s abnormal copper metabolism may promote the growth of intracranial lipoma.ConclusionThe pathogenesis of WD combined with intracranial lipoma and corpus callosum dysplasia is complex and clinically rare. The growth of intracranial lipomas may be associated with abnormal copper metabolism in WD. Abnormal copper metabolism affects lipid metabolism and triggers inflammatory responses. Therefore, early diagnosis and treatment are beneficial for improvement. Each new case of this rare co-morbidity is important as it allows for a better assessment and understanding of these cases’ more characteristic clinical manifestations, which can help estimate the course of the disease and possible therapeutic options.

Giant Quadrigeminal Cistern Lipoma: A Case Report and Literature Review

AbstractWe report the case of a giant lipoma of the quadrigeminal cistern in a 30-year-old female patient with headache, nausea, vomiting, and phono and photophobia. Despite the large size of the tumor, conservative treatment was chosen. Intracranial lipomas are rare benign tumors commonly associated with congenital anomalies, and their origin is related to an incorrect embryonic development. The diagnosis is made mainly by cranial computed tomographyand magnetic resonance imaging. The treatment of lipoma can be surgical or conservative, and there is no single treatment for the different patients' cases.

Bilateral cerebellopontine angle lipomas in an infant with encephalocele: illustrative case.

Bilateral cerebellopontine angle (CPA) lipomas are extremely rare. Herein the authors present a case of bilateral CPA lipomas in an infant along with a literature review of bilateral CPA lipomas. A newborn girl was incidentally found to have bilateral CPA lipomas during the workup for an occipital encephalocele. The encephalocele was repaired primarily on day 2 after birth. The patient demonstrated no symptoms associated with the bilateral CPA lipomas. Eight cases of bilateral CPA lipomas were identified in the literature review and are summarized. Conservative management is the consensus strategy, given minimum growth of the tumor and the high risk of surgical intervention. This is the first reported case of bilateral CPA lipomas in an infant as well as the first with a coexisting intracranial malformation. Intracranial lipomas share an extremely low growth rate and typically do not cause severe symptoms. The management of asymptomatic or mildly symptomatic bilateral CPA lipomas is usually conservative.

Relationship Between Pericallosal Lipoma and Neuropsychiatric Symptoms: A Case Report.

Intracranial lipomas are extremely rare fat-containing lesions that occur due to the abnormal differentiation of embryonic meninges. Interhemispheric lipomas that are closely related to the corpus callosum are also referred to as pericallosal lipomas and are the most common subtype. Pericallosal lipomas are associated with varying degrees of dysgenesis of the corpus callosum and therefore have a broad clinical presentation. Herein, we describe a case of a 15-year-old man who presented with a history of developmental delay and psychiatric symptoms and was incidentally found to have a pericallosal lipoma on magnetic resonance imaging, prompting clinical correlation.

Intracranial lipoma associated with a subcutaneous lipoma

Intracranial lipomas are rare, frequently asymptomatic, congenital malformations. They are most commonly located in the pericallosal region and are often detected incidentally during neuroimaging studies or postmortem examinations. While other associated brain malformations, most notably callosal agenesis, are frequently reported, association with a subcutaneous scalp lipoma is extremely rare. We present a case of pericallosal lipoma associated with callosal agenesis and subcutaneous lipoma over the anterior fontanelle in a 6-month-old female infant who had excision of only the extracranial mass and has remained asymptomatic from the intracranial mass for the 3 years of follow up.

Vascular anomaly, lipoma, and polymicrogyria associated with schizencephaly: developmental and diagnostic insights. Illustrative case.

Schizencephaly is an uncommon central nervous system malformation. Intracranial lipomas are also rare, accounting for approximately 0.1% of brain "tumors." They are believed to be derived from a persistent meninx primitiva, a neural crest-derived mesenchyme that develops into the dura and leptomeninges. The authors present a case of heterotopic adipose tissue and a nonshunting arterial vascular malformation arising within a schizencephalic cleft in a 22-year-old male. Imaging showed right frontal gray matter abnormality and an associated suspected arteriovenous malformation with evidence of hemorrhage. Brain magnetic resonance imaging revealed right frontal polymicrogyria lining an open-lip schizencephaly, periventricular heterotopic gray matter, fat within the schizencephalic cleft, and gradient echo hypointensity concerning for prior hemorrhage. Histological assessment demonstrated mature adipose tissue with large-bore, thick-walled, irregular arteries. Mural calcifications and subendothelial cushions suggesting nonlaminar blood flow were observed. There were no arterialized veins or direct transitions from the arteries to veins. Hemosiderin deposition was scant, and hemorrhage was not present. The final diagnosis was consistent with ectopic mature adipose tissue and arteries with meningocerebral cicatrix. This example of a complex maldevelopment of derivatives of the meninx primitiva in association with cortical maldevelopment highlights the unique challenges from both a radiological and histological perspective during diagnostic workup.

A Clinical Case Report About an Intracranial Lipoma

Intracranial lipoma is a uncommon congenital malformation, represent less than 0.1% of all intracranial tumors. Result from abnormal persistence and mal-differentiation of meninx primitiva, during embryogenesis. The cases in which the tumor presents an extracranial component are caused by a secondary dehiscence of the skull with evagination of a small tuft of primitive meninges. These lesions are frequently located in the inter-hemispheric fissure in the pericallosal region in 50% of cases, other locations as ambient or quadrigeminal cisterns present an incidence about 20-25%. In half of cases the patients present associate midline brain malformations of varying severity, the most frequent is the agenesia of the corpus callosus. The most accepted theory states that in embryonic phases, mesenchymal alterations at the level of the cranial sutures in the sagittal plane can cause anomalies of the SSS, sinus rectum, tentorium, and parietal bones that would explain the associated anomalies. Majority of intracranial lipomas are detected incidentally, being a third of the asymptomatic cases. As in all other pathologies certain localizations cause specific symptomatology of the involved area. The most common clinical manifestations are headache, epilepsy, mental dysfunctions and cranial nerve deficits. The clinical diagnosis is unclear and it is necessary release complementary exams in every suspected cases. Neuroimaging studies such as computed tomography (CT) or magnetic resonance imaging (MRI) make possible identify these lesions. We describe a clinical case about a 79-year-old woman with headache without any other symptoms. Was done CT and MRI that showed a inter-hemispheric lesion located in the pericallosal region, without any other abnormality associated. The development, during the last decades, of neuroimaging and histogenesis techniques increased the knowledge about this pathology and modified the management in recent times. The surgery is contraindicated in the majority of the cases, however still play a role in some cases especially in presence of hydrocephalus, uncontrollable seizures, and bony affectation with cosmetic influence. The medical control of the epilepsy is mandatory. We present a clinical case about pericallosal intracranial lipoma and review the current literature. Taking in account the clinical situation and the imaging findings, we decide for a conservative approach with clinical/neurological and radiological follow-up.

Neuroimaging Spectrum of Intracranial Lipomas.

Intracranial lipomas are rare congenital malformations at characteristic sites. Though largely asymptomatic, some cause significant morbidity. We are studying this for the local population. Objectives: The purpose of this article is to analyze the spectrum of intracranial lipomas, determine their distribution at characteristic locations, and assess their associations. Method: A retrospective study of 21 patients diagnosed with intracranial lipomas detected on CT and MRI performed between September 2017 and May 2022 at Dr. D.Y. Patil Medical College, Hospital & Research Center, Pune. Amongst the21 patients with intracranial lipomas, the most common locationwas the pericallosal region seen in 11 patients (n = 11, 52.3%), of which nine were curvilinear type (n = 9), more common than tubular nodular type (n = 2). Other locations (n = 10, 47.7%) were found to be; quadrigeminal cistern in six patients (28.5%), cranial diploic space in two patients (9.5%), one each ininterhemispheric falx (4.8%), and cribriform plate (4.8%). Associated anomalies were observed in three patients, which werefronto-ethmoidal encephalocele (n = 1), partial agenesis of the corpus callosum (n = 2), extension with a frontal subcutaneous lipoma (n = 1), and bilateral intraventricular extension (n = 1). Presenting symptoms were headache and dizziness (38.1%), seizures (19%), swelling on the forehead (9.5%), and other non-specific clinical symptoms (33.3%). Intracranial lipomas are rare congenital lesions that are usually asymptomatic and discovered incidentally. However, lipomas at interhemispheric locations can cause seizure disorders and some present with headaches and dizziness. Few have associations like communication with extracranial swellings and corpus callosum agenesis.

The Unicorn Mouse: Cranial Lipoma in a B6.Cg Mouse

Intracranial lipomas, also called intracranial lipomatous hamartomas, have been reported in some strains of research mice, but are rare in C57BL6 strains. It is presumed based on current publications that this is the first report of an intracranial lipoma in a mouse with this genetic change (B6.Cg-Cnpy2 tm1.2 Zhli Alb-Cre). Grossly, a fur-covered, soft, cylindrical, exophytic mass on the dorsal midline of the cranium was evident. Upon dissection, a soft, white, tubular structure extended through a 1mm defect in the sagittal suture of the skull to the deep surface of the hypodermis. Histologically, the mass consisted of well demarcated proliferation of mature white adipocytes, each containing one large fat droplet. The mass extended from the cerebrum at the level just caudal to the hippocampus in the third ventricle, between the superior colliculus and the caudal portion of the retrosplenial area and through the sagittal suture to the hypodermis and was surrounded by normal brain tissue.

Intracranial lipomas: Clinical and radiological analysis of 153 cases and review of the literature

Intracranial lipomas: Clinical and radiological analysis of 153 cases and review of the literature

Lipoma of the Corpus callosum: Report of a Case and Review of the Literature.

Intracranial lipomas account for less than 1% of all brain tumors. Corpus callosum lipoma (CCL) is a rare finding and up until now, documented cases are around 200 patients. These lipomas remain mostly asymptomatic, but when symptoms appear, they present through headache, seizure, dementia and in some cases, rather uncommon neurological disorders such as mirror writing. Fourteen years old girl with history of 8 years headache and recent development of vertigo, extremities trembling and drop attack was referred to neurologist and brain imaging confirmed CCL. Herein, we report another rare case of CCL, with common and uncommon symptoms of latter tumor in detail; in addition to reviewing the previous 80 years case reports aiming to achieve comprehensive perception from CCL. Keywords: Lipoma, Corpus callosum, Brain tumors.

Radio-anatomical aspects of a rare case: interpeduncular lipoma

Intracranial lipomas can be associated with other congenital abnormalities, but they are commonly found incidentally on imaging studies. Although the location of intracranial lipomas can be quite variable, they are extremely rare in interpeduncular fossa. We report a case of interpeduncular lipoma with its radio-anatomical features in terms of distinction with pathologies that can appear similarly, as the unexpected location of rare cases can be challenging for radiologists. The MR images of a 55-year-old male patient suffering from episodic dizziness attacks and impaired walking showed two different lipoma masses in interpeduncular fossa and chiasmatic cistern which are isointense with adipose tissue in T1, T2-weighted and FLAIR sequences. Intracranial lipomas can be located in the corpus callosum and almost in all cisterns, however they are extremely rare in interpeduncular fossa. Due to the mass effect, the structures located in close proximity of the lipomas should be evaluated.

Lipoma of the Quadrigeminal Plate Cistern: Two Case Reports with Review of Literature

Intracranial lipomas are benign tumors of rare occurrence representing <0.1% of all primary brain tumors, most often discovered incidentally. Most lipomas were incidentally detected by autopsy or computed tomography (CT). These benign, slow-growing lesions are usually asymptomatic and rarely require surgical intervention. We report two cases of lipomas of the quadrigeminal cistern discovered incidentally on brain MRI, the first case was a 15-year-old adolescent with essential tremor, and the second case was a 40-year-old man with chronic tinnitus with vertigo. In both patients no signs of intracranial hypertension or compression of neural structures were found. Radiological findings were not related to symptoms. The imaging appearance of tectal lamina lipomas on CT and MRI, as well as the different differential diagnoses with a brief review of the literature is presented.

Lipoma of the corpus callosum: Fat in the brain

Intracranial lipomas are very rare, slow-growing, and benign tumors usually asymptomatic but occasionally associated with symptoms like a seizure. This rare occurrence is usually diagnosed incidentally and magnetic resonance imaging is the choice of investigation and diagnosis can be confirmed with fat suppression sequences. Management of corpus callosal lipoma is mainly conservative management with surgery not indicated due to the location and its peripheral structures. Managing seizure is the mainstay of the treatment. We present a case of incidentally diagnosed tubulonodular corpus callosal lipoma after having an event of a fall injury.

SAT-240 Hypothalamic Lipoma and Growth Hormone Deficiency

Introduction: Intracranial lipomas are rare, congenital lesions, most often located at the midline. Most hypothalamic lipomas are asymptomatic, but some cases have been associated with precocious puberty, hypothermia, headache and/or obesity.Case: A 7-year-old boy was referred for short stature, and proved to be partially growth-hormone deficient. Magnetic resonance imaging (MRI) revealed a lipoma in the paramedian hypothalamus. Growth hormone treatment resulted in swift and uncomplicated catch-up growth.Discussion: The present case appears to be the first to link hypothalamic lipoma to GH deficiency. The neuro-endocrine pathophysiology underpinning this link remains to be explored.

Complete third nerve palsy as a presenting feature of an interpeduncular lipoma

Background Intracranial lipomas are rare, benign lesions, of congenital origin commonly found incidentally on imaging studies. Methods We describe a case of interpeduncular lipoma in an 18 year-old female presenting with a painful left complete oculomotor (IIIrd) nerve palsy and associated headache, which to the best of our knowledge has not been reported in an adult patient. Results Following eye patching and steroid treatment, at 6-week follow-up the patient’s pain had significantly improved however the complete IIIrd nerve palsy remained. Conclusions Evidence suggests improvement will occur regardless with conservative management independent of radiological changes to the lipoma.

Beware of artifacts in orbital magnetic resonance imaging.

Orbital magnetic resonance imaging (MRI) is plagued by many artifacts, that sometimes closely mimic pathology.[1] We review the most common artifacts in clinical practice.[2] 2.1 Motion artifacts Optic neuritis is characterized by T2 hyperintensity of the optic nerves [Fig. 1a]. Similar changes can also be produced by motion artifacts [Fig. 1b], which are recognizable by the associated blurring of nerve outlines and ghosting [Fig. 1b and c]. Repeating the scan with the patient fixing the gaze removes these artifacts [Fig. 1d].Figure 1: (a) Bilateral optic neuritis, (b) Eye motion during scanning causes motion artifacts, (c) Motion also produces ghosting and blurring, (d) Repeat MRI of the patient in Figure 1b during eye fixation2.2 Partial volume artifacts Signal changes similar to optic neuritis [Fig. 2a] can occasionally be seen in normal optic nerves [Fig. 2b]. This occurs when the nerves are tortuous and the MR section includes adjacent fat, which artifactually increases signal in the nerve [Fig. 2c]. Fat suppressed sequences [Fig. 2d] are immune to this artifact.Figure 2: (a) Right optic neuritis, (b) Similar changes in both optic nerves produced by partial volume artifact, (c) Genesis of partial volume artifacts, (d) Fat saturated scan shows normal optic nervesSimilar phenomena can affect the extraocular muscles. Extraocular muscles are enlarged and show T2 hyperintensity in disorders such as orbital myositis [Fig. 3a] and thyroid ophthalmopathy. However, even normally, the lateral rectus muscles can appear bulky and hyperintense to rest of the muscles on coronal images [Fig. 3b]. Oblique orientation of lateral rectus muscles to the coronal plane makes them more susceptible to this phenomenon [Fig. 3c].Figure 3: (a) Orbital myositis, (b) Bulky, hyperintense lateral rectus muscles in a normal individual, (c) Obliquity of lateral rectus makes it more prone for partial volume artifact2.3 Susceptibility artifact Signal changes produced by disorders affecting the inferior rectus muscle, such as myositis [Fig. 4a] can occasionally be seen on fat saturated sequences, in individuals with metallic dental implants [Fig. 4b]. Disturbance of the magnetic field along the floor of the orbit by dental implants or air in the maxillary sinus interferes with fat saturation and creates a false appearance of edematous changes [Fig. 4c]. The artefact is recognizable as it extends beyond the muscle boundaries and is worst inferiorly. A similar artefact can be seen when the patient uses eye makeup (mascara) containing metallic iron particles.Figure 4: (a) Inferior rectus myositis, (b) Susceptibility artefact due to dental implants (*) causes hyperintensity of all tissues along the orbital floor, (c) Magnetic field disturbance by the metallic dental implant extends into the orbital floor (dotted line)2.4 Chemical shift artifact The appearance of tumor deposits along the optic nerve [Fig. 5a] can be seen even in normal individuals [Fig. 5b] as the so-called “Chemical shift artifact.” This artifact is typically seen at the interface between fluid and fat containing structures (such as optic nerve and retroorbital fat) as a band of dark signal intensity on one side (along the frequency encoding direction). This is caused by “mis-mapping” (shift) of the signal from retroorbital fat, in relation to the perioptic fluid [Fig. 5c]. Fat suppressed sequences [Fig. 5d] are immune to this artifact.Figure 5: (a) Leukemic deposits on left optic nerve, (b) Curvilinear bands of bright and dark signal along superior and inferior aspects of optic nerves in a normal individual, (c) Illustration of chemical shift artifact, (d) Fat saturated scan in the same individual shows normal optic nervesThis artifact is also seen at the margin of fat containing structures surrounded by fluid (e.g., silicone oil in the globe or intracranial lipomas) and fluid containing structures surrounded by fat (e.g., cysts or hemangiomas within the retroorbital fat). Presence of this artifact gives vital clues in the diagnosis of these conditions. 2.5 Financial support and sponsorship Nil. 2.6 Conflicts of interest There are no conflicts of interest.