Clinical Neurology and Neurosurgery 115 (2013) 2280–2283 Contents lists available at ScienceDirect Clinical Neurology and Neurosurgery j o ur nal hom epage: www.elsevier.com/locate/clineuro Case report Lipomas of the cerebellopontine angle: Neuroradiological and surgical considerations. Review of the literature and report of our experience Assunta Scuotto a,* , Salvatore Cappabianca b,1 , Chiara D’Errico c,2 , Sossio Cirillo a,3 , Massimo Natale d,4 , Raffaele D’Avanzo d,5 , Michele Rotondo d,6 a Neuroradiology, Second University of Naples, Naples, Italy b Radiology, Second University of Naples, Naples, Italy c Otology, Second University of Naples, Naples, Italy d Neurosurgery, Second University of Naples, Naples, Italy a r t i c l e i n f o Article history: Received 11 June 2012 Received in revised form 15 July 2013 Accepted 22 July 2013 Available online 2 August 2013 Keywords: Lipomas Cerebellopontine angle Internal auditory canal Magnetic resonance imaging 1. Introduction Intracranial lipomas are extremely rare lesions, representing 0.08% in autopsy series and being most frequently located in the corpus callosum. Abbreviations: MR, magnetic resonance; CPA, cerebello pontine angle; IAC, inter- nal auditory canal. * Corresponding author at: Neuroradiology, Second University of Naples, Ospedale CTO, V.le Colli Aminei, 21, 80121 Naples, Italy. Tel.: +39 0812545575; fax: +39 0817414288. E-mail addresses: assunta.scuotto@unina2.it (A. Scuotto), salvatore.cappabianca@unina2.it (S. Cappabianca), chiaraderrico@gmail.com (C. D’Errico), cirillos@alice.it (S. Cirillo), massimo.natale@unina2.it (M. Natale), raffaele.davanzo@unina2.it (R. D’Avanzo), michele.rotondo@unina2.it (M. Rotondo). 1 Radiology, Second University of Naples, Piazza Miraglia, 2, 80100 Naples, Italy. Tel.: +39 0815665201; fax: +39 0815665202. 2 Otology, Piazza Miraglia, 2, 80100 Naples, Italy. Tel.: +39 081566 6636; fax: +39 081566635. 3 Neuroradiology, Second University of Naples, Ospedale CTO, V.le Colli Aminei, 21, 80121 Naples, Italy. Tel.: +39 0812545685; fax: +39 0817414288. 4 Neurosurgery, Ospedale CTO, V.le Colli Aminei, 21, 80121 Naples, Italy. Tel.: +39 0812545710; fax: +39 0815665455. 5 Neurosurgery, Ospedale CTO, V.le Colli Aminei, 21, 80121 Naples, Italy. Tel.: +39 0812545558; fax: +39 0815665455. 6 Neurosurgery, Ospedale CTO, V.le Colli Aminei, 21, 80121 Naples, Italy. Tel.: +39 0812545712; fax: +39 0815665455. They rarely occur in the cerebellopontine angle (CPA) or in the internal auditory canal (IAC), a region in which up to 90% of tumors are vestibular schwannomas [1]. They typically present with cochleovestibular symptoms – such as hearing loss, vertigo or balance disorders, tinnitus – with occa- sionally facial neuropathies and trigeminal neuralgia, and rarely brain stem compression. Unlike other benign lesions of the skull base, CPA/IAC lipomas often engulf cranial nerve fibers as opposed to simply compressing theme, complicating attempts of surgical resection [2]. Nowadays conservative treatment is widely recommended especially taking into account that these tumors are slow growing and indolent lesions. We review the relevant literature and describe two new cases of CPA/IAC lipomas, diagnosed on MR and conservatively managed according to their clinical and radiological features. 2. Case reports 2.1. Case 1 A 37-year-old otherwise healthy man presented with a 1-year history of left-sided hearing loss. Audiometric evaluation demonstrated a down sloping sen- sorineural hearing loss in the left ear. The rest of his neurological examination was unremarkable. 0303-8467/$ – see front matter © 2013 Published by Elsevier B.V. http://dx.doi.org/10.1016/j.clineuro.2013.07.029