BrazJOtorhinolaryngol.2016;82(6):741---742
www.bjorl.org
Brazilian
Journal
of
OTORHINOLARYNGOLOGY
CASE
REPORT
Cerebellopontine
angle
lipoma
in
asymptomatic
patients:
case
report
夽
Lipoma
do
ângulo
pontocerebelar
em
pacientes
assintomáticos:
relato
de
caso
Ricardo
Rodrigues
Figueiredo
a,b,∗,
Andréia
Aparecida
de
Azevedo
c,
João
Alfredo
de
Mesquita
Rodrigues
Figueiredo
d,
Norma
de
Oliveira
Penido
aaUniversidadeFederaldeSãoPaulo(UNIFESP),SãoPaulo,SP,Brazil
bFaculdadedeMedicinadeValenc¸a,Servic¸odeOtorrinolaringologia,Valenc¸a,RJ,Brazil cOtorrinolaringologiaSul-Fluminense(OTOSUL),VoltaRedonda,RJ,Brazil
dUniversidadeUnigranrio,RiodeJaneiro,RJ,Brazil
Received13December2014;accepted4May2015 Availableonline5November2015
Introduction
Lipomasrepresentapproximately0.15%ofcerebellopontine angle tumors.1 Audiometric findings include unilateral or
asymmetrical sensorineural hearing loss with low speech
recognition index (SRI).2 Imaging procedures, particularly
nuclearmagneticresonance(NMR),confirmthediagnosis.1---4
There is no image enhancement with gadolinium; in this
scenario,specialfatsuppressionsequencesareparticularly
useful.3Inasymptomaticandmildlysymptomaticpatients,
the treatment is expectant,and surgical approachshould
bereserved for casesof dizziness, aswell asintense and
clinicallyintractabletrigeminalneuralgiaandheadache.3,4
Case
report
GPS, male, 30 years old, asymptomatic, referred after a
changeinperiodicaudiometry.Theaudiometryshowedmild
夽 Please cite this article as: Figueiredo RR, de Azevedo AA,
Figueiredo JA, Penido NO. Cerebellopontine angle lipoma in asymptomatic patients: case report. Braz J Otorhinolaryngol. 2016;82:741---2.
∗Correspondingauthor.
E-mail:rfigueiredo@otosul.com.br(R.R.Figueiredo).
sensorineuralhearingloss,withaflatcurveintheleftear,
andSRIwas100%inboth ears.Brainstemevokedauditory
potential (BEAP) revealed increase in left I---III interpeak
interval.NMRof theinternal auditorycanalsand
cerebel-lopontineangles(CPA)showedasmallextra-axialelongated
imageofapproximately0.8cmingreatestdiameterinthe
upper portion of the left cerebellopontine angle cistern,
thatexhibitedafat-likesignalintensitywhichdisappeared
withtheuseoffat-suppressiontechnique.TheNeurosurgery
Servicechosewatchfulwaitingandaudiometricfollow-up.
Afteroneyear,arepeataudiogram wasperformedwitha
secondNMR;thesizeofthelesion(Fig.1)wasunchanged,
andtherewasnoworseningofhearingthresholds bypure
toneaudiometry.
Discussion
Unlike most cases described,1---4 this patient was
asymp-tomaticatthetimeofdiagnosis.The audiometricfindings
(unilateralsensorineuralhearingloss)arecharacteristicof
retrocochlearlesions,exceptforthenormalSRI.1No
refer-enceswerefoundwithregardofBEAPfindings(I---IIIinterval
increase),whichwascompatiblewithretrocochlearlesions.
As in other retrococlear lesions,NMR is the diagnostic
technique of choice to identify the criticalfeatures of a
http://dx.doi.org/10.1016/j.bjorl.2015.10.003
742 FigueiredoRRetal.
Figure1 Magneticresonanceimagingshows thelesion (cir-cledinblue).
lipoma,theabsence of imageenhancement with
gadolin-ium and the disappearance of the lesion with the use of
fat-suppression techniques.3,4 Given the slow growth of
the lesion, there is consensus in the literature that
sur-gical treatment only is indicated for cases withclinically
intractablesymptoms.2,3
Final
comments
CPA lipomas are rare lesions that behave like and should
betreatedsimilartoothertumorsthatoccurin thesame
region.Ourexampleofanasymptomaticcaseisunusual.
Conflicts
of
interest
Theauthorsdeclarenoconflictsofinterest.
References
1.BorgesRS,BritoCCB,CarvalhoGA,DominguesRC, Gasparetto EL.Cerebellopontineanglelipomasmagneticresonanceimaging intwocases.ArqNeuropsiquiatr.2009;67:496---8.
2.Ferreira MP, Ferreira NP, Lenhardt R. Lipoma of the cere-bellopontine angle. Case reports and litterature review. Arq Neuropsiquiatr.1994;52:58---63.
3.TruwittCL,BarkovichAJ.Pathogenesisofintracraniallipoma:an MRstudyin42patients.AJR.1990;155:855---64.
