Quadrigeminal cistern lipoma

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Quadrigeminal cistern lipomas make up approximately 25% of intracranial lipomas and are located within the quadrigeminal cistern. They may be associated with hypoplasia of the inferior colliculus or agenesis of the corpus callosum.

For a general discussion please refer to the article on intracranial lipomas.

Clinical presentation

They are usually asymptomatic and are usually found incidentally. Rarely do they cause mass effect resulting in seizures or hydrocephalus ⁷.

Radiographic features

CT and MRI findings are characteristic for a fat-containing mass or lesion, however located in the quadrigeminal cistern.

CT

CT demonstrates a lobulated, non-enhancing fat density mass in the quadrigeminal cistern. Peripheral calcifications can be present in some cases.

MRI

MRI reveals signal characteristic of fat:

T1: high signal intensity
T2: high signal intensity
T1 C+ (Gd): no enhancement
fat saturated sequences: low signal intensity
SWI: can produce blooming due to susceptibility artifact ⁸

Treatment and prognosis

Lipomas, in general, are mostly asymptomatic. If there is mass effect causing seizures or hydrocephalus, then surgical management can be considered ^4,6,7.

Differential diagnosis

Differentials specific to its location (quadrigeminal palate) include tectal plate glioma or mass, tectal plate cyst, arachnoid cyst, dermoid cyst and epidermoid cyst ⁷.

-</ul><h4>Treatment and prognosis</h4><p>Lipomas, in general, are mostly asymptomatic. If there is mass effect causing seizures or hydrocephalus, then surgical management can be considered <sup>4,6,7</sup>. </p><h4>Differential diagnosis</h4><p>Differentials specific to its location (quadrigeminal palate) include tectal plate glioma or mass, <a title="tectal plate cyst" href="/articles/tectal-plate-cyst">tectal plate cyst</a>, <a title="Arachnoid cyst" href="/articles/arachnoid-cyst">arachnoid cyst</a>, <a title="Intracranial dermoid cyst" href="/articles/intracranial-dermoid-cyst-1">dermoid cyst</a> and <a title="Intracranial epidermoid cyst" href="/articles/intracranial-epidermoid-cyst">epidermoid cyst</a> <sup>7</sup>.</p>
+</ul><h4>Treatment and prognosis</h4><p>Lipomas, in general, are mostly asymptomatic. If there is mass effect causing seizures or hydrocephalus, then surgical management can be considered <sup>4,6,7</sup>. </p><h4>Differential diagnosis</h4><p>Differentials specific to its location (quadrigeminal palate) include tectal plate glioma or mass, <a href="/articles/tectal-plate-cyst">tectal plate cyst</a>, <a href="/articles/arachnoid-cyst">arachnoid cyst</a>, <a href="/articles/intracranial-dermoid-cyst-1">dermoid cyst</a> and <a href="/articles/intracranial-epidermoid-cyst">epidermoid cyst</a> <sup>7</sup>.</p>

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Image 13 MRI (T1) ( create )

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