Cerebellopontine angle lipoma

Last revised by Mostafa Elfeky on 20 Nov 2022

Cerebellopontine angle (CPA) lipomas account for ~10% of all intracranial lipomas.

Characteristically lipomas of the CPA have the trigeminal nerve, facial nerve and vestibulocochlear nerve coursing through it with the latter two on their way to the internal auditory canal. They are associated with intravestibular lipomas and sensorineural hearing loss. 

They are often asymptomatic. Due to their location and the associated cranial nerves, if symptomatic, patients commonly present with trigeminal neuralgia, facial symptoms, hearing deficit, vertigo or tinnitus 4,5.

They appear as lobulated, non-enhancing, uniform fat density mass (~-100 HU) at the CPA.

Signal characteristics are those of a lipoma:

  • T1: high signal

  • T2: high signal

  • true FISP/FIESTA: low signal margin due to chemical shift artifact

  • fat-saturated sequences: shows signal dropout

For a general discussion of the differential, refer to:

The differential for lesions with high T1 signal includes:

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