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. INTRODUCTION.

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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 SfarUniversityHospital Center, Mahdia, Tunisia

NR10


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.


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.


Axial and sagittal CT scans : Low density inter-hemispheric lesion

with Low-attenuation values indicative of fat


DISCUSSION


CORPUS CALLOSUM ANATOMY

  • The corpus callosumis a wide, flat bundle of neural fibers beneath the cortex in the eutherian brain at the longitudinal fissure.

  • Theposterior 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

  • Therostrum is the part of the corpus callosum that projects posteriorly and inferiorly from the anterior most genu


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


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…


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.

  • It’s considered as a congénital brain malformation rather than a true neoplasm and it’s often associated with partial or complete corpus callosum agenesis


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


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.


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: 39–42


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: 39–42


TREATEMENT AND EVOLUTION

  • There’s 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.


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.


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