Presentation
Incidental finding, evaluated for mood swings.
Patient Data
There is partial agenesis of the corpus callosum. Only the anterior half of the body of corpus callosum is present. The posterior body, splenium and rostrum of the corpus callosum are absent, together with the cingulate gyrus. The lateral ventricles have parallel orientation with colpocephaly marked on the right.
A large midline lobulated fat-containing mass, consistent with a tubulonodular lipoma, is centered within the interhemispheric fissure measuring 3.7 x 5.4 x 3.1 cm. The lesion has irregular margin, with two apparently separate small nodular intraventricular components.
Hyperplastic anterior cerebral arteries are draped and partially incorporated into the lesion.
Following contrast administration, faint enhancement is observed within the central component of the lesion with further irregular enhancements identified at the edge of the lesion. This appears related to vascular enhancement/artefact, rather than true tumoral enhancement.
Normal grey-white matter differentiation is observed with evidence of gross cortical abnormality is seen to suggest cortical dysplasia.
Sinus disease is incidentally noted.
Case Discussion
Pericallosal lipomas come in two distinct varieties - curvilinear and tubulonodular (this case), with the latter being far more impressive and associated with greater degree callosal dysgenesis.
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