Cerebellopontine angle lipoma
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At the time the article was created Frank Gaillard had no recorded disclosures.View Frank Gaillard's current disclosures
At the time the article was last revised Mostafa El-Feky had no financial relationships to ineligible companies to disclose.View Mostafa El-Feky's current disclosures
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.
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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 generic article on intracranial lipomas
differentials of a cerebellopontine angle mass
The differential for lesions with high T1 signal includes:
hemorrhagic vestibular schwannoma
thrombosed berry aneurysm
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- 3. Dahlen RT, Johnson CE, Harnsberger HR et-al. CT and MR imaging characteristics of intravestibular lipoma. AJNR Am J Neuroradiol. 2002;23 (8): 1413-7. AJNR Am J Neuroradiol (full text) - Pubmed citation
- 4. Lagman C, Choy W, Lee S et al. A Case of Bell’s Palsy with an Incidental Finding of a Cerebellopontine Angle Lipoma. Cureus. 2016;8(8):e747. doi:10.7759/cureus.747 - Pubmed
- 5. Bhoi S & Naik S. Cerebellopontine Angle Lipoma Manifesting as Trigeminal Neuralgia. J Pediatr. 2020;222:250. doi:10.1016/j.jpeds.2020.03.037 - Pubmed