LIPOMA

• Kazner E, et al: Intracranial lipoma, diagnostic and therapeutic considerations, J Neurosurg 52, 234-245, 1980
  
• Friedman RB, et al: Computerized tomographic and magnetic resonance imaging of intracranial lipoma, J Neurosurg 65,407-410, 1986
  

Corpus callosum
Quadrigeminal cistern

• Nikaido Y, et al:Lipoma in the quadrigeminal cistern, Neurol Med Chir(Tokyo) 35,175-178, 1995
  

• Leibrock LG, et al: Cerebellopontine angle lipoma: a review 12,697-699, 1983
  

• Ogasawara K, et al:Intracranial lipoma in the sylvian fissure , CT Kenkyu 10, 355-358, 1988(Jpn)
  

• Sasaki H et al: Lipoma of the frontal lobe. Clin Neurol Neurosurg 98:27-31,1996
  

CASE

A 48-year-old female complained right facial sensory disturbance and mild headache. Eye movement disturbance was not detected. CT scan showed the low-intensity mass with calcification in the upper cerebellum. MRI revealed the high intensity mass in T1 emphasis image. Angiography showed the vascular-rich mass and the enlargement of left superior cerebellar artery. Surgery was done in 22/12/87. Occipital transtentorial approach was used. The mass was evacuated almost totally. However, left trochlear nerve palsy appeared postoperatively. The microscopic diagnosis was lipoma. There was the trochlear nerve in the tumor tissue.
Lipoma in the quadrigeminal cistern is also called as lipoma in the superior medullary velum, the superior vermis, the quadrigeminal plate. The symptom is always asymptomatic and the tumor rarely causes hydrocephalus, convulsion, cerebellar symptoms, and upward gaze palsy.
Intracranial lipoma has severe adhesion with surrounding tissue and high vascularity. Main artery and nerve also penetrate in the tumor. Therefore operative indication should be restricted.