Intracranial lipomatous hamartoma (lipoma). Presentation of two cases.

Abstract

Intracranial lipomas are very rare, probably congenital lesions. Although they can occur in any part of the intracranial space, a good proportion of cases tend to be located around the midline or adjacent areas especially the corpus callosum (50%) followed in order of frequency by the quadrigramine lamina, other reported locations include the vermis cerebellar and the pontocerebellar angle.

There are two cases of lipomatous hamartoma, diagnosed in our center, in the last 10 years, of a total of 788 brain biopsies performed.

Case 1: 56-year-old woman consulted for vertiginous syndrome of months of evolution, so a brain tomography was performed, which showed a solid, heterogeneous nodular image measuring 22 mm, located in the cerebellum. The neurosurgery department decided to surgical intervention of the lesion with biopsy for intraoperative study, which after its evaluation was reported as negative for malignancy with definitive diagnosis by deferred study. With the reported result, the total removal of the lesion was decided. In the average macroscopic examination 23x18x15 mm., It was nodular, solid well delimited, to the yellowish cut with whitish areas. In the histological study, in addition to the predominant component of adipose tissue, blood vessels were observed with marked wall thickening, nerve fillets and fibroconnective tissue.

Case 2: A 62-year-old woman consulted due to severe headache, for which reason she underwent a cerebral tomography that showed a heterogeneous tumor lesion of 18 mm, located in the quadrigeminal lamina. A lumpectomy was performed and sent to our center. Macroscopically the lesion was nodular, solid white-yellowish. Microscopically it showed adipose tissue tracts of fibroconnective tissue and congestive vessels.

Lipomas used to be reported primarily as incidental findings at autopsy. Advances in neuroimaging techniques have greatly improved the possibility of being discovered during life.