Pontomesencephalic angle lipoma

Case contributed by Senai Goitom Sereke
Diagnosis almost certain

Presentation

Right sided headache with tinnitus and vertigo

Patient Data

Age: 50 years
Gender: Female
This study is a stack
Axial
T1
This study is a stack
Axial
T2
This study is a stack
Coronal
T2
This study is a stack
Axial
FLAIR
This study is a stack
Sagittal
FLAIR
This study is a stack
Axial
FLAIR fs
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
This study is a stack
Axial
Gradient Echo
This study is a stack
Axial
T1 C+
This study is a stack
Coronal
T1 C+
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Info

Well-defined lesion in the right pontomesencephalic angle, that demonstrated homogenous hyperintensity on T1, T2 and FLAIR with complete hypointensity on the fat sat sequence, and mild mass effect on the adjacent midbrain and mamillary body, is most likely lipoma.

Case Discussion

Intracranial lipomas are found incidentally during neuroimaging for other indications. Pontomesencephalic angle is not a common site for a lipoma, rather cerebellopontine angle accounts for around 10% of all intracranial lipomas.

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