ABSTRACT
BACKGROUND: Intracranial lipomas are extremely rare tumors, with certain clinical and radiological characteristics. METHODS: We considered the diagnostic evaluation and treatment options of seven patients presenting with lipoma in the cerebellopontine angle or internal acoustic meatus in our department. RESULTS: Mean age was 51, with four out of seven cases being women. Balance disorders (vertigo, dizziness) were the predominant symptoms (in six out of seven patients), followed by hearing loss. The diagnosis of intracranial lipomas was based on the results of imaging studies, especially on magnetic resonance imaging. The management of lipomas of the CPA and of the IAM should initially be conservative, including close follow-up of the patient and evaluation of a potential change in tumor size. Surgical management of CPA lipomas should be reserved for patients with intractable clinical symptoms due to tumor overgrowth. CONCLUSIONS: Diagnosis of CPA and IAM lipomas is considered to be a clinical and imaging challenge. As the complete resection of such lipomas is a risky choice and taking into account the benign course of such tumors, the only absolute surgical indication should be uncontrolled tumor growth.
Subject(s)
Choristoma/surgery , Lipoma/surgery , Meninges , Neuroma, Acoustic/surgery , Petrous Bone/surgery , Skull Neoplasms/surgery , Adult , Choristoma/diagnosis , Choristoma/pathology , Diagnosis, Differential , Female , Humans , Image Enhancement , Image Interpretation, Computer-Assisted , Lipoma/diagnosis , Lipoma/pathology , Magnetic Resonance Imaging , Male , Middle Aged , Neuroma, Acoustic/diagnosis , Neuroma, Acoustic/pathology , Petrous Bone/pathology , Skull Neoplasms/diagnosis , Skull Neoplasms/pathologyABSTRACT
Hamman's syndrome is the classical association of subcutaneous emphysema and pneumomediastinum, with or without pneumothorax. Its onset during the expulsive phase of childbirth is exceptional. We report here the first case associated with pharyngeal rupture at the level of the piriform sinus and describe the warning signs and the management by endoscopy.
