Cerebellopontine angle lipoma

Case contributed by Dr Mostafa El-Feky

Presentation

Left ear pain and left hearing impairment.

Patient Data

Age: 10 years
Gender: Female
CT

Petrous bone

The left cerebellopontine angel showed nearly rounded shaped lesion with pure fat density and smooth borders. It measures 1.8 x 1.3 x 1.4 cm in AP, SS and CC dimensions. Anterior inferior cerebellar artery (AICA) loop is seen coursing through it. It is located lateral to the left side of the medullopontine junction and inferolateral to the left middle cerebellar peduncle.

Impacted ear wax bilaterally with narrowing and thickening of soft tissue linings of both external auditory canals.

Case Discussion

CT features are consistent with intracranial lipoma at the left cerebellopontine angle. As regards its location on CT opposite the internal auditory meatus, MRI should be done as CPA lipoma is known to have cranial nerves coursing through it and to detect associated intra-vestibular lipomas. 

Intracranial lipomas in an infratentorial location are extremely rare. CPA lipoma represents about 10% of intracranial lipomas and 0.05% ~ 0.15% of all CPA tumors. They are rarely symptomatic. Accurate preoperative diagnosis is important because most CPA lipomas are managed conservatively. Partial surgical resection is indicated only to alleviate intractable cranial neuropathies or relieve brainstem compression.

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Case information

rID: 57303
Published: 20th Dec 2017
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Dar El Ashaa Center

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