Debelius A, Rudolph J, Schrom T
Klinik für Hals-Nasen-Ohrenheilkunde, Humboldt-Universität zu Berlin, Charité Campus Mitte.
Laryngorhinootologie. 2006 Feb;85(2):128-31. doi: 10.1055/s-2005-870116.
Lipomas of the cerebellopontine angle are rare. Until today in the english literature only isolated cases are described. The most frequent symptoms are: hearing loss (62,2 %), vertigo (43,3 %) and tinnitus (42,2 %). With the help of MRI intracranial lipomas can be diagnosed almost certainly.
A 26 year old patient presented himself to our outpatient departement with recurrent vertigo and tinnitus since two months. Electronystagmography and caloric testing showed a unilateral weakness of the right vestibular organ. Audiometric examination revealed a Normacusis on the right side. BERA resulted in borderline prolonged interpeaklatency on the right side, wave I-V. MRI showed a ca. 5x8x11 mm Lipoma of the right cerebellopontine angel which surrounded the vestibulocochlear nerve. In contrast to schwannomas which are often described in this area the lesion did not enhance contrast medium. On the native T1 sequence the tumor was hyperintense and fat-supression images confirmed the tumor to be fat in origin. Because of the minor symptoms and the small size of the tumor we recommended a BERA after six months and an MRI every year.
The therapeutic options of a lipoma of the cerebellopontine angel depend on the clinical symptoms and a radiologic confirmed progression of size. Because of the received data until today an operative therapy is only indicated when symptoms clinically can not be treated or the leason seems to be a well differentiated liposarcoma.
桥小脑角脂肪瘤罕见。直至今日,英文文献中仅描述过个别病例。最常见的症状为:听力损失(62.2%)、眩晕(43.3%)和耳鸣(42.2%)。借助磁共振成像(MRI)几乎可以确诊颅内脂肪瘤。
一名26岁患者因两个月来反复出现眩晕和耳鸣前来我院门诊。眼震电图和冷热试验显示右侧前庭器官单侧功能减退。听力检查显示右侧听力正常。脑干听觉诱发电位(BERA)结果显示右侧I-V波峰间潜伏期临界延长。MRI显示右侧桥小脑角有一个约5×8×11毫米的脂肪瘤,包绕前庭蜗神经。与该区域常描述的神经鞘瘤不同,该病变未强化造影剂。在T1加权像上肿瘤呈高信号,脂肪抑制图像证实肿瘤起源于脂肪。由于症状较轻且肿瘤较小,我们建议六个月后进行一次BERA检查,每年进行一次MRI检查。
桥小脑角脂肪瘤的治疗方案取决于临床症状和影像学证实的肿瘤大小进展情况。基于目前所获得的数据,仅在临床症状无法治疗或病变疑似为高分化脂肪肉瘤时才考虑手术治疗。