Quadrigeminal plate cistern lipoma

Abstract

Intracranial lipomas are rare benign neoplasms accounting for <0.1% of all primary brain tumours. Most lipomas were incidentally detected by autopsy or computed tomography (CT).These slow growing benign lesions are usually asymptomatic and rarely require surgery. We report the case of a 70-year-old Nigerian woman who presented with persistent headaches following involvement in a road traffic accident 20 days previously. CT demonstrated a quadrigeminal cistern lipoma with no evidence of raised intracranial pressure or compression of neural structures. Her headaches resolved with conservative care. We describe the CT findings with a brief review of the literature.

A rare case of quadrigeminal plate lipoma presenting with the sixth cranial nerve palsy

“…Septum pellucidum was found to be absent [ Figure 4]. Treatment of intracranial lipoma depends on the size and location of tumour and can be managed conservatively and surgically if the tumour is causing an mass effect [13] . Primary objectives in the management of quadrigeminal region lipomas include obtaining definitive histology of the lesion, normalizing CSF dynamics, achieving maximum lesion excision and relieving local pressure effects [2] .…”

Quadrigeminal cistern lipoma

“…(6) These lesions needs to be differentiated with other lesions of quadrigeminal cistern region including arachnoid cysts, tectal plate cyst, tectal gliomas, abscess, dermoid and epidermoid cysts, and rarely pineal region tumors. (3,10) As in present case, asymptomatic lesions which are identified on neuroimaging may not need any surgical intervention except reassurance and management of the headache. (4-6, 13) However, if there are features of mass effect than the patient may need decompression of the lesion and or CSF diversion procedure i.e.…”

“…(3) Characteristic and definitive radiological findings have been described for quadrigeminal cistern lipoma hence histological confirmation is almost never required. (3,5,6,10) As in present case, on CT scan the quadrigeminal cistern lipoma is characterized by non-enhancing hypodense lesions with attenuation values of fat density (-50 to -100 Hounsfield units). (5,11,12) MRI will provide greater details and on MRI these lesions has short T1 and T2 and are hyperintense T1-weighted images and a relatively low to moderately hperintense on T2-weighted images.…”

“…(1)(2)(3)(4)(5) A 30 year female presented with headache of one and half year duration. There was no history of fever, vomiting, loss of consciousness or focal deficits.…”

Intracranial Lipoma: A Rare Variant of Brain Tumor

“…MRI brain repeated after few years of regular follow up revealed no increase in size of the mass Intracranial lipoma is a benign slow growing congenital lesion, which accounts for <0.1% of all primary brain tumors. 1,2 This congenital aberration stems from abnormal differentiation of persistent menix primitive, an area that constitutes the inner level of pia, arachnoid and dura mater. 3 They can be found anywhere intracranially.…”