Tectal lipoma
Tectal lipoma. Intracranial lipomas are rare benign congenital tumours, consisting of <0. One Case Discussion. As CT and fat-saturated sequences (or presence of chemical shift artifact) are usually able to confirm that the mass is fatty the differential is narrowed further: dermoid : mature teratoma. As surgical biopsy can have significant morbidity in this area, usually the diagnosis is made on imaging findings alone. Tectal plate lipoma Case contributed by Heba Abdelmonem. 9 years, range 1. 9-8. In the minority of patients who progress, radiotherapy often Jul 20, 2023 · Citation, DOI, disclosures and article data. Because these supposedly benign tumors are frequently followed up by observation over many years, the authors undertook this analysis of their own case series in an effort to demonstrate that the clinical course is highly variable and that there is a potential for a progressive biology. A tectal lipoma is usually accidental findings and rarely presents with symptoms (about 20% of patients). 1-17. We retrospectively studied TGs treated or referred for review at St. Lipomas are rare in central nervous system. • Most lipomas grow very slowly or not at all, and conservative management is advised in the absence of symptoms and signs. Earn CME for Neuroradiology, Pediatrics, and MRI in many formats including video, interactive DICOM, quizzes, Online Fellowships, and more. Anatomy Diagnosis is based on initial suspicion fostered by the presentation of an obstructive hydrocephalus followed by physical exam which may potentially reveal indications of pyramidal tract A patient with congenital hydrocephalus and poor vision since early childhood, but with normal motor and intellectual development, suffered progressive mental deterioration during the last decade of life. Microscopically, the locus ceruleus was unilaterally invaded by a tumor in one case and may have been compressed in the other. Lipomas are rare in Jan 1, 2008 · Tectal plate gliomas represent a particular type of brain stem tumours usually with a benign, indolent. The lesion was hypointense on fat-saturated T1 and SWI (due to susceptibility artefact) sequences without post-contrast enhancement, compatible with lipoma. 1% of all primary brain tumours. 7 years) and 6 Computerized tomography and magnetic resonance imaging demonstrated a quadrigeminal cistern lipoma compressing the aqueduct of Sylvius. Median age at diagnosis was 9. • Surgery on intracranial lipomas Mar 1, 2024 · The quadrigeminal plate , also known as the tectal plate or tectum, is constituted by the superior and inferior colliculi. Sep 16, 2014 · The differential diagnoses of lipomas in the quadrigeminal cistern include: arachnoid cysts, tectal plate cyst, tectal masses (gliomas), supracerebellar abscess, dermoid and epidermoid cysts, ruptured P4 segment aneurysm of the posterior cerebral artery and, rarely, pineal region mass. Patients may be asymptomatic or present with rectal bleeding, constipation, tenesmus and signs of intestinal obstruction. This female fetus was a product of pregnancy termination at 24 weeks of gestational age after sonographic detection These cases included; tuber cinereum lipoma, pericallosal lipoma, trigeminal nerve lipoma, tectal plate lipoma, falx lipoma. Quadrigeminal cistern lipomas make up approximately 25% of intracranial lipomas and are located within the quadrigeminal cistern. 10-15% of intracranial lipomas are in the tectal region. May 31, 2018 · Citation, DOI, disclosures and article data. Methods A cohort of patients with tectal plate gliomas at 2 academic institutions was retrospectively reviewed. IL is located in the midline regions such as the corpus callosum and quadrigeminal plate [4]. 7 tectal plate lipomas and 3 non glial tumours involving the tectal plate were identified. 3 years (median 7. They are anteriorly situated and are associated with extensive callosal and often fronto-facial anomalies. 08 to 0. 3 (interquartile range: 4. The tectum is the dorsal portion of the midbrain ( brainstem ), located posteriorly to the mesencephalic aqueduct. Another locations of lipomas include: basal cistern, cerebral hemispheres, tectal plate, pontocerebellar angle and spinal, cervical cord, respectively, considering the frequency of incidence. Esta área del cerebro controla funciones corporales importantes como la Apr 27, 2024 · Benign lipomas are circumscribed soft masses, usually encapsulated, and composed almost entirely of fat. They comprise 50% of soft-tissue neoplasms and are commonly encountered by primary care physicians, surgeons, and pathologists. Adipocytes and fibrous tissue were present adjacent to pial surfaces and around small blood It is confirmed that the World Health Organization has approved the use of nanofiltration membranes for the recovery of phosphorous-contaminated wastewater from the Mediterranean Sea and Atlantic Ocean. 4,5 The lipoma can be differentiated with other negative Apr 20, 2023 · INTRODUCTION. These Abstract. The patient underwent endoscopic assisted microsurgery via an infratentorial supracerebellar approach. The common symptoms are intracranial hypertension and obstructive hydrocephalus which are treated by shunting surgery. (Bottom) Fat-suppression techniques should make the lesion appear dark, as on this axial T2-weighted fat-saturated sequence. Nov 20, 2022 · Intracranial lipomas are widely distributed in the intracranial compartment. The patient underwent surgery and a distinct plane of cleavage between the lipoma and the adjacent neural structures was found, allowing total removal of the lesion. Keywords: Tectal plate; quadrigeminal cistern, lipoma; imaging. Usually incidental and asymptomatic. 14%). Although they can be found essentially anywhere, certain regions are characteristic: pericallosal lipoma (50%) associated with agenesis of the corpus callosum in ~50% of cases. Nov 5, 2022 · Intracranial lipomas are rare benign congenital tumours, consisting of <0. This female fetus was a product of pregnancy termination at 24 weeks of gestational age after sonographic detection Jul 13, 2023 · The differential diagnosis for a suprasellar cistern lipoma is very limited and is essentially that of pituitary region masses with intrinsic high T1. Any Age. vein of Galen aneurysmal malformation May 27, 2014 · The differential diagnoses of lipomas in the quadrigeminal cistern include: arachnoid cysts, tectal plate cyst, tectal masses (gliomas), supracerebellar abscess, dermoid and epidermoid cysts, ruptured P4 segment aneurysm of the posterior cerebral artery and, rarely, pineal region mass. Generally, occur in midline structure and usually identified incidentally on CT Nov 5, 2022 · Intracranial lipomas are rare benign congenital tumours, consisting of <0. primary pineal malignant melanoma 5. They form around 0. There has been no detailed analysis of molecular alterations in TG. Methods: From 2004 until 2012, 71 patients with tectal plate LGG from Germany and Switzerland were followed within the SIOP-LGG 2004 study. Jun 4, 2023 · The boundaries of the quadrigeminal cistern are as follows 2: anterior: quadrigeminal plate of the midbrain (or colliculi) posterior: the meeting point of tentorium cerebelli and falx cerebri. Results: Five patients with intracranial lipomas were identified (0. 4103/1793-5482. M=F. View. clinical course, presenting with signs of raised intracranial hipertension due to supra A 35-year-old female who presented with psychosis with predominant visual hallucinations, which suspected an underlying organic pathology and brain imaging showed the presence of quadrigeminal cistern lipoma is reported to report a very rare condition with an even more atypical associated presentation. Lipomas were located in the midline (3 cases), in the tectal region, and over the parietal cortex. A decision was made to operate on the patient in order to decompress the tectal plate. inclusion cysts (dermoid/epidermoid) 4. 06–0. Symptoms of rectal cancer usually happen when the disease is advanced. Lipomas are uniformly T1 hyperintense and maintain signal isointense to fat on all pulse sequences. Benign and malignant pathologies occurring in this location may lead to aqueductal stenosis, obstructive hydrocephalus, and Parinaud syndrome. Many papers have described different types of pathology arising in that location including tumors, vascular lesions, inflammatory and infectious processes. They are usually asymptomatic, but may also present with seizures, raised intracranial pressure, dementia, hemiparesis, persistent headaches, psychomotor retardation and cranial nerve defects. 5 Jul 28, 2020 · Purpose Intra-axial “pineal region” tumors include pineal, tectal, and aqueductal tumors. Result: Other lesions that must be included in the differential diagnosis of quadrigeminal cistern lipoma are dermoid and epidermoid cyst, arachnoid cyst, tectal plate cysts and masses. In high-resolution MRIs, a study found a high prevalence of asymptomatic cysts in 23% of healthy subjects 6. 1 Interhemispheric lipomas are the most common type about 45% and the others are quadrigeminal or superior cerebellar (25%), suprasellar or interpeduncular (14%), cerebellopontine angle (9%) and sylvian (5%). Lipoma in quardrigeminal area could give rise to symptoms of psychosis. Among these, tectal plate lipoma presenting with psychosis is a very rare entity and till now only one such case has been reported . It is a benign neoplasm (lipoma) of the mid brain (brain stem) as noted by the location "tectal plate. The goal of this manuscript is to describe the radiological, clinical, and pathological nuances that differentiate between these subgroups Methods: All admissions to our epilepsy monitoring unit who had had brain MRI were reviewed for intracranial lipomas during 6 consecutive years. Dec 5, 2022 · Pericallosal lipoma (45%) - In 50% of instances, this is accompanied by corpus callous agenesis. 2 years who harbored tectal plate gliomas were included in the study. superior: splenium of the corpus callosum. Methods: A cohort of patients with tectal plate gliomas at 2 academic institutions was retrospectively reviewed. 1% of all primary Several studies have reported that ventral midbrain or pontine lesions can cause hallucinosis. They are asymptomatic and are thus incidentally discovered whenever brain imaging is advised due to any other organic cause. These more observatory protocols as seen in dorsal cord lipomas and thus should avoid unnecessary surgeries in future. MRI Online offers micro learning content that fits your busy schedule. Dec 22, 2009 · CT demonstrated a quadrigeminal cistern lipoma with no evidence of raised intracranial pressure or compression of neural structures. CSF would have values close to 0 HU while air would be below -800 HU. Anatomy: Diagnosis is based on initial suspicion fostered by the presentation of an obstructive hydrocephalus followed by physical exam which may Lipomas are easily identified on CT but may also be mistaken for CSF or air depending on the windowing values. 46% of intracranial lesions, forming a rare type of congenital malformation. These benign lesions are slow-growing, usually asymptomatic and rarely require surgery. A small amount of non-adipose components are often present, representing fibrous septa, areas of fat necrosis, blood vessels, and interposed muscle fibers. The quadrigeminal cistern is continuous with the following cisterns 3: Jan 1, 1997 · A case of congenital tectal lipoma found incidentally at an autopsy is reported. 4. In this paper we describe our experience in treating seven patients with tectal plate lesions, with different ages and types of pathology: five Diagnosis: Quadrigeminal plate cistern lipoma/tectal plate lipoma Discussion Intracranial lipomas are rare, slow-growing, benign congenital lesions accounting for 0. Preoperative diagnosis is challenging. Furthermore, possible vascular etiology of the headache in this patient would prompt a trial of anti-migraine drugs in addition to the expectant management of tectal lipoma. Show abstract. 2. We encountered a 35-year-old male patient with a tectal lipoma presenting with holocranial headache. It is seen with a Chiari type II malformation. Jun 1, 2012 · Abstract. Jul 1, 2017 · Literature review demonstrated 59 cases of duodenal lipoma, which indicate that duodenal lipomas are rare to occur but commonly found in the second part. inferior: vermis of cerebellum. They are demarcated from surrounding fat by a thin, fibrous capsule. The tectal plate comprises the posterior portion of the midbrain, borders the quadrigeminal cistern, and includes the superior and inferior colliculi. RESUMEN. 5. The mean clinical and radiological follow-up was 7. Introducción Los tumores de la región tectal constituyen, dentro del apartado de los gliomas del tronco del encéfalo, un subgrupo de mejor pronóstico que requiere una estrategia terapéutica distinta. . • Lipomas may be associated with additional dystrophic and congenital malformations. Ossification may also occur, particularly in suprasellar and interpeduncular lipomas. Results Forty-four patients with a mean age of 10. Lipomas are slow-growing, benign, mesenchymal tumors that form well-circumscribed, lobulated lesions composed of adipocytes. Since then, intracranial lipomas have being routinely Learn about Neuroradiology, Pediatrics, and MRI in this course. Her headaches resolved with conservative care. Apr 24, 2013 · Introduction Tectal plate gliomas are generally benign neoplastic lesions arising in the brainstem which can, with local extension, obstruct the aqueduct of Sylvius and lead to hydrocephalus. 26 Tectal plate lipoma This is a reportable brain tumor. 3) years. 1% of all primary brain tumors [1,2]. 3. Lipoma is a common benign mesenchymal-induced tumor with variable distribution. Cerebellopontine angle lipoma (10%) - This type of lipoma affects the facial nerve and vestibulocochlear nerve. and radiologically stable for years after cerebrospinal uid Feb 10, 2017 · These images show a T1 hypertense, T2 FLAIR hyperintense mass of the tectal plate which becomes hypointense on T2 fat-saturated images compatible with a lipo Nov 6, 1996 · A case of congenital tectal lipoma found incidentally at an autopsy is reported. 8x2. 5 percent of all primary brain tumors and are usually detected as incidental findings. 34 It has also been illustrated in a study that revealed differences in inferior colliculus Intracranial lipomas are rare developmental lesions of the central nervous system, which are usually asymptomatic and discovered incidentally. Most commonly, they occur in the trigonal choroid plexus There was associated hypoplasia of the corpus callosum and the cerebellum supporting the diagnosis of intracranial lipoma or dermoid tumour. Results: Forty-four patients with a mean age of 10. rare vascular lesions. Presenting is a case of 39 year old female patient of schizophrenia who presented with visual hallucinations since 1. They may be associated with hypoplasia of the inferior colliculus or agenesis of the corpus callosum. This female fetus was a product of pregnancy termination at 24 weeks of gestational age after sonographic detection of hydrocephalus. Duodenal lipomas may present as gastrointestinal bleeding, abdominal pain, obstruction or upper abdominal fullness. The patient is on regular follow up for 1 year, with no evidence of progression of symptoms. 5) Pineal Region Lipoma: Synonym: Lipomatous hamartoma. These lipomas can rarely present with acute psychosis or schizophrenia-like symptoms characterised by abnormal perceptions, cognition, mood, and behaviour. This area of the brain controls important body functions like breathing, heart rate, and blood pressure. It derives from the alar plate of the neural tube during embryonic development. Figure 2: Axial (top left) and sagittal (top right) T1-weighted Tectal lipoma presenting with headache: An unusual etiology! Asian J Neurosurg. These lipomas can rarely present with acute psychosis or schizoph … Nov 5, 2022 · MRI brain pinpointed the tumour’s location to the quadrigeminal cistern (tectal plate). 5) years, and median follow-up time of surviving patients was 6. Autopsy revealed a small mass in the periaqueductal portion. At necropsy he was found to have severe hydrocephalus secondary to a lipoma of the midbrain tectum obstructing the aqueduct of Sylvius. Lipomas of the gastrointestinal tract are uncommon, benign non-epithelial tumors detected incidentally during surgery or endoscopy. The imaging appearance of tectal lamina lipomas on CT and MRI, as well as the different differential diagnoses with a brief review of the literature is presented. Sep 25, 2018 · Tectal glioma (TG) is a rare low-grade tumor occurring predominantly in the pediatric population. 4x9 mm lesion with a hyperintense signal on T1 and T2-weighted MRI images was observed. 7 (range: 0. On CT examination, a quadrigeminal cistern lipoma without any pressure effect on Mar 18, 2024 · Tubulonodular pericallosal lipomas are the more common variety. They mainly occur in the region of the corpus callosum and the pericallosal cistern, accounting for up to 65% of all intracranial lipomas and frequently associated with callosal dysgenesis. • Lipomas are most commonly found in the midline and are frequently asymptomatic. doi: 10. 5-14. Jude Children’s Research Hospital (SJCRH) between Aug 5, 2023 · Unlike intracranial lipoma that follows fat density on all sequences, intracranial dermoid has more variable signal characteristics 1-4: T1. cavernoma in the pineal region. These Nov 16, 2020 · In the quadrigeminal cistern adjacent to the Tectum, approximately 3. Rectal lipomas are extremely rare. Interhemispheric lipoma associated with subcutaneous component is extremely rare. meningioma near the pineal region. Rectal cancer may not cause symptoms early on. These A review of the current literature of quadrigeminal lipoma cases with presenting symptoms is provided. 01% of all central nervous system tumors and arise primarily due to abnormalities in the development of meninx primitiva. Figure 1: This tectal plate lipoma demonstrates low density of fat on CT imaging (top left) and hyperintensity on T1WI (top right). Of the 12 patients with proven histology the average age at diagnosis was 24 years with all but 3 presenting with hydrocephalus, which was successfully Sep 25, 2018 · Tectal glioma (TG) is a rare low-grade tumor occurring predominantly in the pediatric population. We also included a case of lipomatous dermoid. Postoperatively, the patient was relieved of Un glioma tectal (de un tipo de célula glial que nutre y sostiene otras células cerebrales) es un tumor cerebral de crecimiento lento, generalmente benigno (que no se disemina), en niños de 3 a 16 años de edad, situado en la parte superior del tronco encefálico. A feeling that the bowel doesn't empty completely. Tectal beaking refers to the fusion of the midbrain colliculi into a single beak pointing posteriorly and invaginating into the cerebellum. divided morphologically into tubonodular and curvilinear types. Intracranial lipomas are 0. Suprasellar cistern lipoma (15%). The tubulonodular variety can extend into the choroid plexus and/or lateral ventricles 2,3,6 . OBJECTIVE Tectal gliomas constitute a rare and inhomogeneous group of lesions with an uncertain clinical course. The quadrigeminal cistern is continuous with the following cisterns 3: Jun 4, 2023 · The boundaries of the quadrigeminal cistern are as follows 2: anterior: quadrigeminal plate of the midbrain (or colliculi) posterior: the meeting point of tentorium cerebelli and falx cerebri. For a general discussion please refer to the article on intracranial Nov 14, 2023 · Intracranial lipomas are only 0. 6,7 The lipoma can be differentiated with other negative Jan 1, 2017 · Tectal plate gliomas. All three tumor subgroups cause obstruction of the aqueduct; however, they differ in radiological nuances, pathology, differential diagnosis, and treatment. Intracranial lipomas are extremely rare benign tumors, accounting for <0. Introduction: Tectal plate gliomas are generally benign neoplastic lesions arising in the brainstem which can, with local extension, obstruct the aqueduct of Sylvius and lead to hydrocephalus. Diagnosis almost certain Share Add to Citation, DOI, disclosures and case data. 25 As such, intracranial lipomas are often Nov 6, 1996 · A case of congenital tectal lipoma found incidentally at an autopsy is reported. Note the slight elevation of the torcular and the normal corpus callosum Intracranial lipomas constitute lesions evolving on the basis of an abnormal differentiation of embryologic primitive meninges. Aug 5, 2010 · CNS lipomas are situated mainly in supratentorial midline (approximately 80% of cases), usually in corpus callosum. Authors Ashish Kumar 1 Mar 2, 2017 · We identified 39 suspected low grade tectal plate gliomas of which 12 had confirmed neuropathology. Quadrigeminal cistern lipomas in themselves are very rare tumours, accounting for 25% of all intracranial lipomas. As tectal plate gliomas are low grade and often very slow growing, shunting is often the only required intervention for long term survival. The goal of this manuscript is to describe the radiological, clinical, and pathological Sagittal T1-weighted image demonstrates the brainstem schisis with posterior traction of the pons and midbrain, and the stretching of the tectal plate by the intracranial lipoma. Management consists of simple observation, endoscopic or Aug 1, 2016 · The imaging appearance of tectal lamina lipomas on CT and MRI, as well as the different differential diagnoses with a brief review of the literature is presented. Quadrigeminal cistern lipoma (25%) - It is related to inferior colliculus underdevelopment. Central or peripheral calcification may be present. Risk factors associated with inferior outcome and long-term sequelae of TG have not been well-documented. In the minority of patients who progress, radiotherapy often MRI brain pinpointed the tumour’s location to the quadrigeminal cistern (tectal plate). One Oct 3, 2023 · Definition. 145063. We report a 20 years old male who complained of headache since two years ago. 1 % of all primary brain neoplasms ( 1 ). 1–3 Septum pellucidum is composed of two thin lamina extending from anterior to posterior from lamina terminalis to corpus callosum splenium with a width between 1. 51–56 The association of tectum with psychosis was first described in an adolescent who suffered from a tectal lipoma and psychosis was preceded by headache. Here, we present a case of tectal lipoma, with subsequent severe hydrocephalus and absence of septum pellucidum which was initially misinterpreted as a form of holoprosencephaly, due to inadequate Here, we present a case of tectal lipoma, with subsequent severe hydrocephalus and absence of septum pellucidum which was initially misinterpreted as a form of holoprosencephaly, due to inadequate May 30, 2020 · Abstract. The peak of incidence seems to be around the fifth and seventh decade of life. [ 1] . Because these supposedly benign tumors are frequently followed up by observation over many years, the authors undertook this analysis of their own case series in an effort to demonstrate that the clinical course is highly variable Nov 1, 2013 · Object Tectal plate gliomas are generally low-grade astrocytomas with favorable prognosis, and observation of the lesion and management of hydrocephalus remain the mainstay of treatment. Oct 18, 2022 · Pineal cysts are typically found in young adults (20-30 years of age) with a predilection for women (3:1 female to male ratio). Lipomas are easily identified on CT but may also be mistaken for CSF or air depending on the windowing values. The occipital cranium bifidum occultum and the lipoencephalocele are also demonstrated. 2 years who harbored tectal plate gliomas were Dec 14, 2017 · Treatment and prognosis. Nov 5, 2022 · MRI brain pinpointed the tumour’s location to the quadrigeminal cistern (tectal plate). represent approximately 5% of pediatric brainstem. Masses in the region of the May 9, 2023 · glioma (usually tectal in origin, astrocytic in histology) (~5% of primary pineal region tumors) pineal metastasis. Both computed tomography and magnetic resonance A tectal lipoma is usually accidental findings and rarely presents with symptoms (about 20% of patients). Purpose: Intra-axial "pineal region" tumors include pineal, tectal, and aqueductal tumors. Meckel was the first to report intracranial lipomas, way back in 1818. 6 ± 3. They are seen in ~5% of brain MRIs and 20-40% of autopsy series. هنیمز فده و : موپیل یا ياه مسلاپوئن لاینارکارتن شوخ ياه دنتسه يردان رایسب میخ ک ه ک م زا رت 1 / 0 % ک ياهروموت ل On CT, lipomas are sharply marginated with markedly low density, usually below –40 HU. A patient with tectal lipoma and callosal dysgenesis first presented with hydrocephalus treated with shunting. They are rounded or lobular and usually measure >2 cm in thickness. Dec 14, 2017 · Treatment and prognosis. Intracranial lipomas (ILs) are rare and account for 0. 46% on autopsies. 2 May 2, 2022 · A tectal glioma (from a type of glial cell that nourishes and supports other brain cells) is a slow growing, generally benign (non-spreading), brain tumor in children 3-16 years of age, situated in the upper portion or roof of the brain stem. gliomas, have a favorable prognosis, and remain clinically. The mass was composed of … Among tumors found in the tectal plate, the most common is the astrocytoma, but other types have been described, such as oligodendroglioma, ependymoma, ganglioglioma, medulloblastoma 3, primitive neuroectodermal tumors, metastasis; as well as lipoma 11, melanoma 12, dysembryoplastic neuroepitelial tumor (DNT) 13, cavernomas, abscess and were not related to symptoms. Background: Intracranial lipomas are rare benign neoplasms that comprise 1% of all primary brain tumors. Intracranial Lipoma. Signs and symptoms of rectal cancer include: A change in bowel habits, such as diarrhea, constipation or a more-frequent need to pass stool. Nov 14, 2023 · Discussion. Citation: Abdelmonem H Jul 1, 2016 · A case of congenital tectal lipoma found incidentally at an autopsy is reported. CNS Lipomas are congenital malformations and not true neoplasms. Objetivos Revisión retrospectiva de los tumores tectales en niños perfilando la actitud terapéutica más idónea y el pronóstico Nov 5, 2022 · Intracranial lipomas are rare benign congenital tumours, consisting of <0. 1-0. Tectal plate is a rare location for a tumor. 24 These lesions are often found over the corpus callosum, the quadrigeminal cistern, the interhemispheric or intercerebellar fissure, as well as the Sylvian fissure. May 18, 2022 · Symptoms. 1 Lipoma in the quadrigeminal region has previously been reported as lipoma in the A provisional diagnosis of quadrigeminal plate lipoma was made, and patient was treated with oral anti-epileptic drugs. 5 years and brain imaging showed Quadrigeminal cistern (tectal plate) lipoma. Conclusion: Recognition of the imaging features of intracranial lipoma in different modalities is essential in accurate diagnosis and follow-up. The incidence of intracranial lipomas is about 0. " 27 Lhermitte-Duclos disease The WHO classification for CNS tumors lists this entity as dysplastic gangliocytoma of the cerebellum Dec 10, 1997 · Key points. Superficial lipomas are usually <5 cm whereas deep lipomas can be >20 cm 10 . They typically have Hounsfield values between -20 to -100 HU (depending on size / partial voluming). typically hyperintense (due to cholesterol components) hyperintense droplets in the subarachnoid spaces may be visible if rupture has occurred; T1 C+ (Gd): generally do not enhance Tectal lipoma presenting with headache: An unusual etiology! Sir, We encountered a 35-year -old male patient with a tectal lipoma presenting with holocranial headache. Jul-Sep 2016;11(3):304. They are usually diagnosed incidentally [3]. Similar cases in future may help Two patients with mixed sleep apnea and autopsy-documented lipomas of the mesencephalic tectum and rostral pons are presented. We describe the CT findings with a brief review of the literature. zn ho vs lq lr sx sh qq sd ll