Revision 31 for 'Quadrigeminal cistern lipoma'

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Quadrigeminal cistern lipoma

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

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 the mass results in mass effect and causes 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

 

Please refer to the generic article on intracranial lipomas for further discussion.

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