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CALLOSAL LIPOMA - keywords

Lipoma of the corpus callosum

Summary

A lipoma of the corpus callosum is a hyperechoic mass in the middle of the interhemispheric fissure, dorsally between the hemispheres or in choroid plexus of lateral or third ventricle (Boechat et al. 1983, Fisher and Cremin 1988, Beltinger and Saule 1988, Truwit and Barkovich 1990, Tart and Quisling 1991, Melin and Keller 1992). Curvilinear lipomas replace the caudal corpus callosum and can rarely extend into lateral ventricle choroid plexus. Choroidal extension of a midline lipoma is not seen with presence of the corpus callosum in loco. Tuberonodal lipomas lie adjacent to genu and trunk of the corpus callosum and can extend to the calvarial bone (Nordin et al. 1955). Extensive lipomas may later cause epilepsy, headaches and mild spastic diparesis (Gastaut et al. 1980, Kieslich et al. 2000). A large fraction remains asymptomatic. Interhemispheric (curvilinear) lipomas must arise from remnants of the primitive meninx, probably later in pregnancy and/or result from a minor insult and do not interfere with the development of the corpus callosum; the ACA is anterior and superior to it. Tuberonodal lipomas originate between the 12th and the 20th week and cause callosal dysgenesis, possibly involving fornix and septum pellucidum, ACA branches embedded in it (List et al. 1946). Callosal fibers are interrupted from crossing by the mass. The anterior commissure develops from the ventral lamina reuniens and is normal. The mass of fat laden cells corresponds to a sharply delineated hypodensity on CT, often with a shell of calcifications. Fat is hyperintense on both T1 and T2 MRI. Ordinarily the normal corpus callosum has been completely replaced by this lipoma. On fetal ultrasound, the main feature leading to detection is a short corpus callosum (Attalah et al. 2018). This callosal dysgenesis is associated with a band of hyperechogenicity surrounding it, mimicking the pericallosal sulcus, increasing in size during the third trimester in some fetuses.
callosal part —>
interhemispheric part —>
On T2-MRI, this band shows typical hypointensity (darkness); in contrast, on T1-weighted imaging the postnatal expected high signal (brightness) of the lipoma may be absent in utero. Increasing detection rates in utero are expected with advancing 3D ultrasound (Pashaj and Merz 2016). Lipomas do not have high flow vessels (Gradowska et al. 2011). With extension into the ventricle cavities the initial suspicion of GMH/IVH in a preterm infant should be corrected by serial scanning (Imaizumi et al. 1988). Extraosseous lipoma or alopecia may alert the clinician. Whereas less than 5 % of all callosal ageneses are associated with lipoma, in reverse 50 % of all fetal brain lipomas are linked with callosal maldevelopment. The lesion is often found in children with spinal dysraphism. Trisomies can also be causal. One peculiar association is frontonasal dysplasia [hypertelorism, bifid nose, agenesis of corpus callosum and frontal interhemispheric lipoma]. Other associations are between CMV fetopathy and callosal lipoma/agenesis, and between callosal lipoma and Goldenhar syndrome (Beltinger and Saule 1988). Pai syndrome is a rare condition with midline craniofacial abnormalities. It was originally described as the presence of a median cleft lip, cutaneous polyps of the nasal mucosa and face, and midline lipomas of the central nervous system, mostly at the corpus callosum (Castori et al. 2007, Olivero et al. 2020). adapted from B Bessières
https://thefetus.net/content/lipoma-of-the-corpus-callosum-2

Examples

  • surprise finding in near term infant
  • 34w GA, trisomy 18
  • 35w GA, IUGR, preauricular tags

References to lipoma of the corpus callosum

  • Atallah A, Lacalm A, Massoud M, Massardier J, Gaucherand P, Guibaud L. Prenatal diagnosis of pericallosal curvilinear lipoma: specific imaging pattern and diagnostic pitfalls. Ultrasound Obstet Gynecol. 2018 Feb;51(2):269-273.
  • Baker LB, Conroy J, Donoghue V, Mullarkey M, Shah N, Murphy N, Murphy J, Ennis S, Lynch SA. Agenesis of the corpus callosum with midline lipoma associated with an Xp22.31-Xp22.12 deletion. Clin Dysmorphol. 2011 Jan;20(1):21-25.
  • Beltinger C, Saule H. Imaging of lipoma of the corpus callosum and intracranial dermoids in the Goldenhar syndrome. Pediatr Radiol 1988;18:72-73
  • Boechat MI, Kangarloo H, Diament MJ, Krauthamer R (1983) Lipoma of the corpus callosum: sonographic appearance. J Clin Ultrasound 11:447-8.
  • Castori M, Rinaldi R, Bianchi A, Caponetti A, Assumma M, Grammatico P. Pai syndrome: first patient with agenesis of the corpus callosum and literature review. Birth Defects Res A Clin Mol Teratol. 2007 Oct;79(10):673-9.
  • Demaerel P, Van de Gaer P, Wilms G, Baert AL. Interhemispheric lipoma with variable callosal dysgenesis: relationship between embryology, morphology, and symptomatology. Eur Radiol 1996;6:904-909
  • Fisher RM, Cremin BJ (1988) Lipoma of the corpus callosum: diagnosis by ultrasound and magnetic resonance. Pediatric Radiology 18:409–410.
  • Gastaut H, Regis H, Gastaut JL, Yermenos E, Low MD. Lipomas of the corpus callosum and epilepsy. Neurology 1980;30:132-138
  • Gradowska K, Czech-Kowalska J, Jurkiewicz E, Komornicka J, Dobrzańska A. Lipomas of the central nervous system in the newborns - a report of eight cases. Pol J Radiol. 2011 Oct;76(4):63-8.
  • Imaizumi SO, Pleasure JR, Zubrow AB. Lesion mistaken for hemorrhage in a premature infant: lipoma of corpus callosum. Pediatr Neurol. 1988 Sep-Oct;4(5):313-6.
  • Kieslich M, Ehlers S, Bollinger M, Jacobi G. Midline developmental anomalies with lipomas in the corpus callosum region. J Child Neurol. 2000 Feb;15(2):85-9.
  • List CF, Holt JF, Everett M. Lipoma of the corpus callosum. Am J Roentgenol Radium Ther. 1946 Feb;55:125-34.
  • Mehta NM, Hartnoll G (2001) Congenital CMV with callosal lipoma and agenesis. Pediatr Neurol 24:222-4.
  • Melin GI, Keller MS (1992) Pericallosal lipoma extending through the choroidal fissure: US/CT/MRI correlation. Neuroradiology 34:402-3.
  • Nordin WA, Tesluk H, Jones RK. Lipoma of the corpus callosum. AMA Arch Neurol Psychiatry. 1955 Sep;74(3):300-7.
  • Olivero F, Foiadelli T, Luzzi S, Marseglia GL, Savasta S. Pai syndrome: a review. Childs Nerv Syst. 2020 Nov;36(11):2635-2640.
  • Pashaj S, Merz E. Detection of Fetal Corpus Callosum Abnormalities by Means of 3D Ultrasound. Ultraschall Med. 2016 Apr;37(2):185-94.
  • Popa RT, Feier D, Fufezan O, Blaga L. Interhemispheric lipoma associated with agenesis of corpus callosum in an infant: case report. Med Ultrason. 2010 Sep;12(3):249-52.
  • Renkema RW, Caron CJJM, Wolvius EB, Dunaway DJ, Forrest CR, Padwa BL, Koudstaal MJ. Central nervous system anomalies in craniofacial microsomia: a systematic review. Int J Oral Maxillofac Surg. 2018 Jan;47(1):27-34.
  • Tart RP, Quisling RG. Curvilinear and tubulonodular varieties of lipoma of the corpus callosum: an MR and CT study. J Comput Assist Tomogr 1991;15:805-810.
  • Truwit CL, Barkovich AJ (1990) Pathogenesis of intracranial lipoma: an MR study in 42 patients. AJNR 11:665