Internal acoustic canal lipoma

Case contributed by Mauricio Macagnan
Diagnosis almost certain


Patient with headache.

Patient Data

Age: 65 years
Gender: Male

Tiny lesion inside the right IAC, measuring 3 mm, with high signal on T1 and low signal in the sequences with fat saturation, compatible with lipid content. After contrast injection, there were no abnormal areas of enhancement.

Red arrow indicates the hyperintense image in T1, hyperintense in T1 C + and not visualized in the fatsat sequence.

Case Discussion

Lipoma of the internal auditory canal (IAC) is an extremely rare lesion and little described in the literature. They are usually asymptomatic and found incidentally. 

Neuroimaging represents an important tool for diagnosis, since it evaluates IAC and cerebellar angle. Symptomatic cases where there is compression of nerve structures, complete resection can be attempted but there is a risk of severe neurological sequelae, especially in large lesions. The most described conduct is the follow-up of the lesion through repeated imaging examinations in order to detect lesion growth.

This case was kindly provided by Dr Rodrigo Dias Duarte.

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