What are the tree most common locations for intracranial lipomas?
Pericallosal, quadrigeminal plate cistern and suprasellar cistern.
What is the main differential for a fat containing lesion in the brain?
The main differential is that of a dermoid cyst, although it tends to have more heterogeneous signal and is usually located in the suprasellar region.
In the pineal region (and elsewhere) what other lesion should be considered?
True or false: Intracranial lipomas are incidental and not associated with any congenital malformations.
True and false (sorry :) ). Although they are usually incidental and usually asymptomatic they are not infrequently associated with hypoplasia / dysplasia of the adjacent brain. This is most commonly seen in pericallosal lipomas which are associated with callosal dysgenesis.
Centered on the left quadrigeminal plate is a mass lesion that has high T1 and T2 signal and has low signal on fat-suppressed imaging. There is no assocaited ventriculomegaly or corpus callosal abnormality. Features are those of a quadrigeminal plate lipoma.