Frontal subcutaneous lipoma associated with large interhemispheric lipoma and corpus callosum agenesis

Abstract

Intracranial lipomas are extremely rare fat-containing lesions that comprise 0.1%-0.5% of all primary brain tumors. They are congenital lesions that arise due to persistence and maldifferentiation of the meninx primitive (subarachnoid space precursor). We report a case of a 30-year-old woman who presented with seizures due to an intracranial lipoma and no neurological deficits. CT (computerized tomography) imaging findings demonstrated a large interhemispheric partially calcified lipoma that communicated with a large scalp lipoma and was associated with agenesis of the corpus callosum. Compared to the prior CT imaging, the lipoma increased in size from 3.4 cm to 4.1 cm transversely. A recent CT angiogram done due to suspicion of an aneurysm showed the lipoma now measuring 6 cm by 4.7 cm. Most cases of intracranial lipoma have been reported in the pediatric age group. Here, we report a rare case of interhemispheric intracranial lipoma in the adult age group. This case also demonstrates the importance of imaging modalities for detecting intracranial lipoma without performing invasive brain biopsy.

Keywords: Interhemispheric intracranial lipoma; Meninx; Neuroradiology; Seizures; Subcutaneous lipoma.

Fig. 1

Head CT scan without contrast from November 2019. (A) Coronal view showing the interhemispheric lipoma. (B) Sagittal view showing the intracranial lipoma communicating with the scalp. (C) Axial view showing the interhemispheric and invasion into the body of the lateral ventricles bilaterally measuring about 3.4 cm.

Fig. 2

Head CT scan without contrast from May 2021. (A) Coronal view showing the interhemispheric lipoma. (B) Sagittal view showing the intracranial lipoma communicating with the scalp which has enlarged from the prior CT scan to 6 cm by 4.1 cm. (C) Axial view showing the interhemispheric and invasion into the body of the lateral ventricles bilaterally. (D) Sagittal view in bone window showing the intracranial lipoma communicating with the scalp.

Fig. 3

Head MRI from May 2021. (A) Coronal view showing the interhemispheric lipoma. (B) Sagittal view showing the intracranial lipoma communicating with the scalp. (C) Axial T2 view showing the interhemispheric and invasion into the body of the lateral ventricles bilaterally.

Fig. 4

CT angiography of brain from June 2021. (A) Coronal view depicting blood vessel going through the lipoma. (B) Axial view show casing the measurement of the lipoma 6 cm by 4.7 cm.