![]() ![]() Classically, these tumors were thought to arise from cells of the meninx primitiva, the mesenchymal derivative of the neural crest, and thus they were referred to as lipomas of the IAC/CPA. These rare tumors of the CPA and IAC are slow growing and often discovered incidentally. Lipochoristomas (lipomatous choristomas) comprise 0.1% of all CPA tumors. Each of these lesions has typical imaging characteristics that frequently allow a diagnosis to be made with magnetic resonance imaging (MRI) scan alone. 1 2 3 Rare tumors include epidermoids, lipochoristomas, and metastatic tumors. Vestibular schwannoma represents the most common lesion in the IAC (80–90%) with meningiomas comprising nearly all the rest (10%) of IAC tumors. Neoplasms arising within the internal acoustic canal (IAC) and cerebellopontine angle (CPA) are most commonly of neuroepithelial origin. Surgical treatment is reserved for growing lesions or those with disabling vestibular symptoms. Because lipochoristomas may have a tendency for more indolent growth and intimate involvement of the auditory nerve, conservative management with interval imaging is recommended. Fat-suppressed MRI sequences aid in a definitive diagnosis of lipochoristomas. The patient remains symptomatically stable with improved equilibrium but persistent left-sided hearing loss.Ĭonclusions Differential diagnosis of an enhancing lesion in the IAC includes acoustic neuroma, meningioma, epidermoid and arachnoid cysts, lipochoristoma, and metastatic tumors. ![]() Conservative management was recommended, and on 17-month follow-up there was no interval growth. A diagnosis of IAC lipochoristoma was made. With fat-suppressed images, there was no enhancement of the lesion. Magnetic resonance imaging (MRI) demonstrated a small (5 × 4 mm) T1 hyperintense lobulated lesion in the distal internal auditory canal. Results (Case Report) A 51-year-old woman presented with left-sided severe hearing loss, tinnitus, mild episodic vertigo, and facial paresthesias progressive over 1 year. Study Design and Methods Retrospective case review. We describe a lipochoristoma of the internal auditory canal (IAC) and present the salient features of the evaluation, diagnosis, and management. Objective Lipochoristomas comprise 0.1% of all cerebellopontine angle tumors and may be misdiagnosed as vestibular schwannomas. ![]()
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