LIPOMA OF THE CORPUS CALLOSUM A CASE REPORT

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LIPOMA OF THE CORPUS CALLOSUM A CASE REPORT
M. SAIDI, Z. KHADIMALLAH, S. JERBI OMEZZINE, K.
BOUSLAMA, K. MRAIDHA, HA. HAMZA Department of
Medical Imaging, Tahar Sfar University Hospital
Center, Mahdia, Tunisia
NR10
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INTRODUCTION

• Lipomas of the corpus callosum are rare
  congenital conditions.
• These lesions are often asymptomatic but may
  present as epilepsy, hemiplegia, dementia or
  headache.
• Computerized tomography and magnetic resonance
  imaging make the diagnosis of lipomas feasible at
  any site of the intracranial space.

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CASE REPORT

• An 18 months-old healthy boy presented at urgency
  with head injury. Axial CT scans with sagittal
  reconstructions were performed.
• CT scans have revealed a low density
  inter-hemispheric lesion (-50 to -70 HU )
  involving the corpus callosum from genu through
  the body into the splenium .
• The Low-attenuation values indicative of fat
  within the lesion and the absence of
  calcification were suggestive of corpus callosum
  lipoma.

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Axial and sagittal CT scans Low density
inter-hemispheric lesion with Low-attenuation
values indicative of fat
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DISCUSSION
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CORPUS CALLOSUM ANATOMY

• The corpus callosum  is a wide, flat bundle of
  neural fibers beneath the cortex in the eutherian
  brain at the longitudinal fissure.
• The posterior portion of the corpus callosum is
  called the splenium the anterior is called
  the genu (or "knee") between the two is the
  truncus, or "body", of the corpus callosum.
• The isthmus is The part between the body and the
  splenium
• The rostrum is the part of the corpus callosum
  that projects posteriorly and inferiorly from the
  anterior most genu

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Sagittal T1-weighted MRI of the brain shows the
normal appearance of the corpus callosum.
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CORPUS CALLOSUM FUNCTIONS

• The corpus callosum is the largest white
  matter structure
• in the brain.
• It connects the left and right cerebral
  hemispheres
• It s involved in several functions of the body
  including
• Communication Between Brain Hemispheres
• Eye Movement
• Maintaining the Balance of Arousal and Attention
• Tactile Localization

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CORPUS CALLOSUM LIPOMA

• Lipomas of the central nervous system are
  extremely uncommon in contrast to those arising
  elsewhere, and are estimated to comprise less
  than 0.1 of all intracranial tumors .
• The majority of intracranial lipomas occur in the
  midline region and corpus callusum lipomas
  represents 30 to 50 of all intracranial lipomas.
• Its considered as a congénital brain
  malformation rather than a true neoplasm and
  its often associated with partial or complete
  corpus callosum agenesis

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CLINICAL MANIFESTATIONS

• A patient with this tumor is often asymptomatic,
  which is the case in our observation, and the
  locc is discovered accidently
• Symptoms depends on associated malformations .
• Patients may suffer from convulsions, mental
  retardation, motor disturbances, headaches,
  visual disturbances, vertigo and vomiting,
  Intracranial hypertension .
• Epilepsy is one of the most frequent symptoms

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DIAGNOSTIC IMAGING CT

• Computed tomography reveals a typical
  interhemispheric lesion of variable extent,
  depending on part or complete involvement of
  corpus callosum..
• Low-attenuation values indicative of fat (-50 to
  -100 HU) can be easily established within the
  lesion.
• Curvilinear calcification has been consistently
  reported however there was no calcification in
  our case.
• The presence of calcifications , prospect
  differential diagnosis with dermoid cysts and
  teratomas, and the diagnosis of corpus callosum
  lipoma could not be certain.

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DIAGNOSTIC IMAGING CT
Axial CT scan interhemispheric hypodense area
containing calcific component.
Axial CT scan low density inter-hemispheric
lesion (-50 to -70 HU ).
Neuroanatomy (2009) 8 3942
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DIAGNOSTIC IMAGING MRI

• MR scans do not leave doubts, infact fat signal
  is characteristically hyper in T1w and T2w
  sequences, and in FATSAT sequences it is
  suppressed

Axial and coronal MR scans interemispheric area
of hyperintensity in T1 and T2, it becomes
hypointense in FS (fat saturation) sequences
Neuroanatomy (2009) 8 3942
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TREATEMENT AND EVOLUTION

• Theres no indication to surgical treatment in
  isolated (pure) corpus callosum lesions on the
  other hand, surgical outcomes are controversial
  because is difficult a complete debulking that
  spare the nervovascular structures involved
• Prognosis and symptoms depends on associated
  malformations .
• Risks to be considered, above all in the
  evolutive age, are hydrocephalus and epilepsy.

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CONCLUSION

• Intra-cranial lipomas are extremely rare brain
  tumors. Lipomas of corpus callosum constitute the
  commonest variety of all intra-cranial lipomas
  and are associated with varying degrees of
  dysgenesis of corpus callosum.
• CT can make the diagnosis but MRI is a procedure
  of choice in the evaluation of corpus callosum
  lipomas and eventual associated malformations.