Acta Neurochir (Wien) (2002) 144: 829–833 Acta Neurochirurgica > Springer-Verlag 2002 Printed in Austria Case Report CerebellarLiponeurocytoma CaseReportwithConsiderationsonPrognosisandManagement F.Cacciola1,R.Conti1,G.L.Taddei2,A.M.Buccoliero2, and N.DiLorenzo1 1 Department of Neurosurgery, University of Florence, Italy 2 Department of Human Pathology and Oncology, University of Florence, Italy Summary Background. Cerebellar liponeurocytoma has only recently been recognized as a distinct clinicopathological entity. Although the few cases described in literature support the relatively benign nature of this lesion, optimum treatment strategy and long term behaviour still have to be defined. Clinical Presentation. This 61-year-old man came under our ob- servation with unspecific signs of intracranial hypertension and a symptomathology revealing a probable posterior fossa lesion. Imag- ing studies showed a cerebellar mass lesion with prevalent adipose content. Intervention. Gross total tumour removal was performed. The pathological examination revealed a lesion composed of medullo- blastoma-like cells with prominent areas of lipidisation. A review of literature has been made in an attempt to investigate on recurrence patterns, importance of the extent of removal and the usefulness of radiotherapy. Conclusion. The few cases reported in literature so far seem to confirm the relatively benign nature of cerebellar liponeurocytoma. No radiotherapy was given in our case and the reasons for this deci- sion are reported. Keywords: Cerebellar neoplasm; lipidisation; radiotherapy; recur- rence. Introduction Cerebellar liponeurocytoma is a rare tumour in- troduced for the first time in the new WHO classifica- tion of brain tumours [9, 12]. Since its first description in1979[3]ithadbeengivenvariousnamesallbasedon the fact that hystopathological examination always essentially revealed a medulloblastoma with heavily lipidised cells. Over the years however, as several other cases of this tumour have been identified and reported in the literature, it became evident that it distinguishes itself from medulloblastoma and its various lines of di¤erentiation due to its significantly more benign be- haviour and older age of incidence. We report on a case of cerebellar liponeurocytoma operated on in our department with a review of the literature, based on the need to obtain prognostic information for the pa- tient and to establish whether to give radiotherapy or not. CasePresentation This 61-year-old man came under our observation with a 2-month history of increasing occipital headache radiating to the frontal re- gion, worse at night and alleviated by clinostatism. During the same period he experienced various sudden episodes of unstable gait of short duration accompanied by nausea and vomiting. In addition he su¤ered from disturbing misperception of sounds and voices he described as hyperacusia. Neurological examination revealed no deficits. The patient underwent a Computed tomographic scan (CT- scan) on admission (Fig. 1) and subsequently magnetic resonance Fig.1. AxialdirectCT-scan,showingarightcerebellarmasswithan abundant hypo-intense component, minimal perilesional edema and a mass e¤ect on the fourth ventricle and basal cisterns