Lipoma of the cerebellopontine angle: case reports and literature review

Abstract

SUMMARY -Two patients with cerebellopontine angle (CPA) lipoma were studied. They were submitted to surgical treatment. Available literature was reviewed and 29 cases with same lesion were identified which had been treated by surgery. Clinical manifestations, possibility of diagnostic methods, surgical indications and treatment strategies are discussed. Attention is called to the peculiarities of CPA lipomas and the doubtful vality of attempting complete excision in all cases.K E Y -W O R D S : cerebellopontine angle, lipoma, surgery.Lipoma do ângulo pontocerebelan relato de casos e revisão da literatura RESUMO -São estudados dois pacientes com lipoma no ângulo pontocerebelar (APC), submetidos a tratamento cirúrgico. A literatura disponível foi revisada, tendo sido identificados 29 casos submetidos a tratamento cirúrgico, com a mesma lesão. As manifestações clínicas, possibilidades dos métodos diagnósticos, indicações cirúrgicas e estratégicas operatórias são discutidas. Chama-se a atenção para as peculiaridades dos lipomas do A P C e a discutível validade da tentativa de remoção completa em todos os casos.

Cerebellopontine angle lipoma in asymptomatic patients: case report

“…Unlike most cases described, 1 , 2 , 3 , 4 this patient was asymptomatic at the time of diagnosis. The audiometric findings (unilateral sensorineural hearing loss) are characteristic of retrocochlear lesions, except for the normal SRI.…”

“… 1 Audiometric findings include unilateral or asymmetrical sensorineural hearing loss with low speech recognition index (SRI). 2 Imaging procedures, particularly nuclear magnetic resonance (NMR), confirm the diagnosis. 1 , 2 , 3 , 4 There is no image enhancement with gadolinium; in this scenario, special fat suppression sequences are particularly useful.…”

“… 2 Imaging procedures, particularly nuclear magnetic resonance (NMR), confirm the diagnosis. 1 , 2 , 3 , 4 There is no image enhancement with gadolinium; in this scenario, special fat suppression sequences are particularly useful. 3 In asymptomatic and mildly symptomatic patients, the treatment is expectant, and surgical approach should be reserved for cases of dizziness, as well as intense and clinically intractable trigeminal neuralgia and headache.…”

Acoustic Neurinoma with Synchronous Ipsilateral Cerebellopontine Angle Lipoma: A Case Report and Review of the Literature

“…Subsequently, we partially separated the lipoma on the opposite side of the tumor from the pyramidal bone, where the facial nerve passed, resulting in the preservation of facial nerve function. This strategy was based on the outcomes of CPA lipoma removal in confirmed cases reported in the literature ( Table 1 and Table 2 ) [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. Most surgeries result in additional neurologic deficits because lipomas often adhere to the brainstem and neurovascular structures, such as the facial nerve, vestibulocochlear nerve, or other lower cranial nerves.…”

Diagnostic Dilemma: Cerebellopontine Angle Lipoma Versus Dermoid Cyst

“…Upon gross inspection, lipomas are yellowish masses enclosed by a translucid capsule [ 28 ]. The histological evaluation of CPA lipomas reveals that they are composed primarily of mature, well-differentiated adipocytes.…”