Vanderbilt University School of Medicine, Nashville, Tennessee, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A.
Laryngoscope. 2021 Sep;131(9):2081-2087. doi: 10.1002/lary.29434. Epub 2021 Feb 10.
OBJECTIVES/HYPOTHESIS: Cerebellopontine angle (CPA) and internal auditory canal (IAC) lipomas are rare, benign tumors comprising 0.08% of all intracranial tumors and can be mistaken for other, more common lesions of the CPA/IAC such as vestibular schwannoma. The purpose of this study was to review the literature and assess the evolution of CPA/IAC lipoma diagnosis and management. In addition, we present 17 new lipomas, matching the largest known case series of this rare tumor.
Retrospective case series and systematic review.
Systematic review of the literature was performed using PubMed and Google Scholar. References from identified articles were also reviewed to identify potential additional manuscripts. Manuscripts and abstracts were reviewed to identify unique cases. For the case series, the charts of all CPA/IAC lipoma patients seen at a single institution from 2006-2019 were manually reviewed. Logistic regression and chi-squared analysis were performed where appropriate.
A total of 219 unique lipomas have been reported in the literature, including 17 presented in this study. Surgical management has been performed in 46% of cases and has been conducted less often in recent decades, likely due to improved radiographic diagnostic capabilities and understanding of surgical outcomes. Surgical management is associated with worse neurologic outcomes (P = .002) and has become less common in recent decades. Although growth is unlikely, it has been demonstrated in patients into their 30s.
Accurate radiographic diagnosis is imperative for appropriate patient management, as CPA/IAC lipomas should typically be managed through observation and serial imaging whereas vestibular schwannomas and other CPA/IAC lesions may require microsurgical or radiosurgical intervention depending on growth and symptomatology. Laryngoscope, 131:2081-2087, 2021.
目的/假设：桥小脑角（CPA）和内听道（IAC）脂肪瘤是罕见的良性肿瘤，占所有颅内肿瘤的 0.08%，可误诊为其他更常见的 CPA/IAC 病变，如前庭神经鞘瘤。本研究的目的是回顾文献并评估 CPA/IAC 脂肪瘤诊断和管理的演变。此外，我们还介绍了 17 例新的脂肪瘤，与这种罕见肿瘤已知的最大病例系列相匹配。
回顾性病例系列和系统评价。
使用 PubMed 和 Google Scholar 进行系统文献回顾。还回顾了已确定文章的参考文献，以确定潜在的其他手稿。审查手稿和摘要以确定独特的病例。对于病例系列，从 2006 年至 2019 年，在一家机构中手动审查了所有 IAC 脂肪瘤患者的图表。在适当的情况下进行逻辑回归和卡方分析。
共报道了 219 例独特的脂肪瘤，其中包括本研究中介绍的 17 例。46%的病例进行了手术治疗，近几十年来手术治疗的频率较低，这可能是由于放射诊断能力的提高和对手术结果的理解。手术治疗与更差的神经功能结局相关（P=0.002），并且在最近几十年变得不那么常见。尽管肿瘤生长不太可能，但在 30 多岁的患者中已得到证实。
准确的影像学诊断对于适当的患者管理至关重要，因为 CPA/IAC 脂肪瘤通常应通过观察和连续影像学检查进行管理，而前庭神经鞘瘤和其他 CPA/IAC 病变可能需要根据生长和症状进行显微手术或放射外科干预。喉镜，131:2081-2087，2021。
