Quadrigeminal cistern lipoma
Incidental finding in a brain MRI requested for headache.
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There is a lobulated, non-enhancing mass with high signal on T1 and T2 (fat signal) in the left side of the quadrigeminal cistern consitent with a lipoma.
There is also another lesion at the prepontine cistern on the right side, with an isointense signal on T1 and hyperintense signal in T2, which enhances intense and homogeneously after the administration of gadolinium, consistent in a meningioma.
Intracranial lipoma is a benign lesion that is often incidentally detected by computed tomography or MRI. Usually asymptomatic and slow-growing benign lesion which rarely requires surgery. Surgical management can be considered if the lesion produces mass effect, causes seizures or hydrocephalus.