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.