0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Clinical Note |

Intravestibular Lipoma An Important Imaging Diagnosis

Meike W. Vernooij, MD; M. Arfan Ikram, MD; Arnaud J. P. E. Vincent, MD, PhD; Monique M. B. Breteler, MD, PhD; Aad van der Lugt, MD, PhD
Arch Otolaryngol Head Neck Surg. 2008;134(11):1225-1228. doi:10.1001/archotol.134.11.1225.
Text Size: A A A
Published online

Extract

Lipomas constitute 0.1% of all intracranial tumors.1 Very rarely they are located in the cerebellopontine angle (CPA) or the internal auditory canal, and even less frequently they have been described in an intravestibular location.24 These lipomas should not be treated surgically because their adherence to nerves and surrounding brain structures often leads to neurological deficits when surgical removal of the lesion is attempted.1 Therefore, it is important to distinguish inner ear and CPA lipomas from more common tumors in the cerebellopontine region, such as acoustic neuromas, which are often treated surgically. Thus, noninvasive diagnosis by radiological imaging is crucial. We report herein a case of intravestibular lipoma that is associated with CPA lipoma and cystic cochleovestibular malformation (incomplete partition type 1) of the inner ear. Diagnostic magnetic resonance imaging (MRI) and computed tomographic (CT) characteristics of lipomas are discussed in detail. Furthermore, this unique combination of intravestibular lipoma with cystic cochleovestibular malformation provides more understanding of the pathophysiologic characteristics of these rare tumors.

Figures in this Article

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Place holder to copy figure label and caption
Figure 1.

Magnetic resonance imaging scans of the infratentorial region. A, Axial conventional (nonenhanced) T1-weighted scan. B, A fat-suppressed T1-weighted scan. In the right cerebellopontine angle and the right vestibule, 2 lesions (white arrows) with marked intrinsic hyperintense signal on the nonenhanced T1-weighted image (A) are seen. The hyperintense signal on T1-weighted imaging is completely suppressed after applying a fat-suppression inversion pulse (B).

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Axial computed tomographic image of the inner ear, bone window. In the right inner ear (A), an enlarged vestibule that incorporates the lateral semicircular canal is seen (white arrow). Also, the cochlea shows incomplete partition, with the upper turns forming a common cavity (black arrow), and there is an absence of the modiolus. In comparison, in the left inner ear (B), a normal anatomy of the cochlea is seen. The findings on the right side are characteristic for cystic cochleovestibular malformation (incomplete partition type 1).

Graphic Jump Location
Place holder to copy figure label and caption
Figure 3.

Axial computed tomographic image of the right inner ear, soft tissue window. Hounsfield attentuation unit (HU) measurements performed of the lesion in the vestibule and cerebellopontine angle show densities corresponding to fat (normally, −50 to −150 HU) (small, medium, and large statistics circles indicate mean [SD] measurements of −145 [15], −126 [10], and 44 [10] HU, respectively). For comparison, densitometry was performed of cerebellar brain tissue as well (large statistics circle), showing densities corresponding to brain tissue (>40 HU).

Graphic Jump Location

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

45 Views
2 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();