Quadrigeminal cistern lipomas make up approximately 25% of intracranial lipomas and are located within the quadrigeminal cistern. They may be associated with hypoplasia of the inferior colliculus or agenesis of the corpus callosum.
For a general discussion please refer to the article on intracranial lipomas.
They are usually asymptomatic and are usually found incidentally. Rarely do they cause mass effect resulting in seizures or hydrocephalus 7.
CT and MRI findings are characteristic for a fat-containing mass or lesion, however located in the quadrigeminal cistern.
CT demonstrates a lobulated, non-enhancing fat density mass in the quadrigeminal cistern. Peripheral calcifications can be present in some cases.
MRI reveals signal characteristic of fat:
- T1: high signal intensity
- T2: high signal intensity
- T1 C+ (Gd): no enhancement
- fat saturated sequences: low signal intensity
- SWI: can produce blooming due to susceptibility artifact 8
Treatment and prognosis
Lipomas, in general, are mostly asymptomatic. If there is mass effect causing seizures or hydrocephalus, then surgical management can be considered 4,6,7.
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- 3. Ogbole, Godwin; Kazaure, Idris; Anas, Ismail. Quadrigeminal plate cistern lipoma BMJ Case Reports. 2009 doi:10.1136/bcr.07.2009.2110
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- 5. Vonderhae AR, Niemer WT. Intracranial lipoma: a report of four cases. J. Neuropathol. Exp. Neurol. 1994; 3: 344–354.
- 6. Eghwrudjakpor PO, Kurisaka M, Fukuoka M et-al. Intracranial lipomas: current perspectives in their diagnosis and treatment. Br J Neurosurg. 1992;6 (2): 139-44. Pubmed citation
- 7. Ogbole G, Kazaure I, Anas I. Quadrigeminal plate cistern lipoma. (2009) BMJ case reports. doi:10.1136/bcr.07.2009.2110 - Pubmed
- 8. Dhaval K Thakkar, Abhijit Patil, Dolly Thakkar, Mansi N Jantre, Vilasrao M Kulkarni, Amarjit Singh. Quadrigeminal cistern lipoma: A rare case report with review of literature. (2015) Medical Journal of Dr. D.Y. Patil University. 8 (2): 267. doi:10.4103/0975-2870.153185