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cerebral lipoma

Thursday 12 March 2009

Intracranial lipomas are infrequent Central Nervous System(CNS) lesions with an incidence that ranges between 0.08 to 0.2% of autopsied cases and between 0.06 to 0.3% among those found during imaging, but according to others this frequency can raise up to 0.4%.

Although these lesions are considered grade I mesenchymal, non-meningothelial tumors according to the World Health Organization, their origin is not clear and the idea of a primary malformation is still accepted. In fact, their origin may arise in the abnormal persistence and abnormal differentiation of the primitive meninx.

These kind of lesions are more frequently detected as a single entity, however, they can also be a component of "encephalocraniocutaneous lipomatosis" a rare neurocutaneous syndrome.

By imaging studies intracranial lipomas are frequently located in the midline, usually in the supratentorial compartment, and more precisely they tend to be interhemispheric in the anterior corpus callosum.

In fact, pericallosal lipomas as a single entity are usually divided into two groups: curvilinear and tubulonodular. The former are thin, posteriorly located in the corpus callosum, and have low incidence of associated anomalies.

On the other hand, tubulonodular lipomas are located anteriorly, and are associated with a high incidence of facial defects and/or encephaloceles.

On MRI, characteristically these lesions are homogenous, and show hyperintensity on T1-weighted images and hypo or isointensity on T2.

Clinically patients can be asymptomatic, present with recurrent headaches, show mental retardation or can present with focal or generalized epilepsy, which has been regarded by some as the most frequent presentation, but this has more recently been challenged.

Case studies

- Case UPMC #596

References

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