Intracranial suprasellar angiolipoma: ultrastructural and immunohistochemical features

A rare case report of infratentorial cisternal angiolipoma with review of literature

Angiolipomas are slow-growing benign mesenchymal-derived tumors consisting of mature adipocytes and thin-walled blood vessels. While the majority of angiolipomas are found in subcutaneous tissues, rarely there are case reports of intracranial lesions. We present a case of cisternal angiolipoma in a 10-year-old female. She presented with vague symptoms like dizziness without neurological deficits and radiological evaluation confirmed a left-sided infratentorial cisternal partially enhancing mass. She underwent craniotomy and had complete resection of the mass, which was histologically composed of mature adipocytes and blood vessels, consistent with angiolipoma. A review of the literature found only 18 cases of intracranial angiolipoma ever reported with our case representing the first case of infratentorial cisternal region.

A Rare Case of Brain Angiolipoma Imitating Arteriovenous Malformation: Differential Diagnosis, Surgical Treatment, and Literature Review

BACKGROUND

Angiolipomas are mesenchymal tumors composed of mature adipocytes with abnormal vascular elements. They are most commonly found in subcutaneous tissues of the trunk and are rarely seen at craniospinal axes.

CASE DESCRIPTION

We present an untypical case of frontal lobe angiolipoma manifested with seizures and initially described as an arteriovenous malformation.

CONCLUSION

MRI with fat-suppression sequence plays key role in angiolipomas diagnostics.

Spinal angiolipoma--case report

A 69-year-old male presented with a rare spinal angiolipoma manifesting as history of back pain, and numbness in both lower limbs, which progressed over a period of 5 years. Total T10-T12 laminectomy was performed and the tumor was removed en bloc. The symptoms gradually improved postoperatively. Spinal angiolipoma is an uncommon benign extradural tumor of spine, which accounts for 0.14-1.2% of all spinal tumors and is a rare cause of spinal cord compression. Recognition of this entity is crucial as a benign and curable cause of paraplegia and back pain.

Lateral sellar angiolipomas: a therapeutic challenge. Our experience on two cases and review of the literature

Angiolipomas are rare benign mesenchymal tumours, most commonly found in the subcutaneous tissue of the extremities. These neoplasms are rarely located in the central nervous system (CNS), with spinal localization being the most common in this group. Intracranial location is extremely infrequent, and only ten cases have been described in the sellar region. We report on two more patients with skull-base (intracranial) angiolipomas, the former presented with a long history of headache and the latter complained diplopia. Both patients were postoperatively verified as angiolipoma. Neuroimaging studies and peroperative features are presented and the role of microsurgery is discussed. On the basis of these tumours' characteristics, the management strategy of choice usually does not consist on surgical total removal, often a partial excision could be satisfying to improve the patient symptomatology. Nowadays, Gamma Knife surgery is standing out as an effective, additional and/or alternative, treatment modality.

Lateral sellar angiolipoma: a tumor illustrative of the extradural compartment of the neural axis

Angiolipomas are rare tumors of the CNS that most frequently develop in the orbit, the cavernous space, and the epidural space of the spine. The authors report the case of a patient who presented with an angiolipoma of the cavernous space. Using data from the published literature and an experimental anatomical approach, they demonstrate that the cavernous space contains adipose tissue. Consequently, they suggest that angiolipomas constitute a characteristic tumor illustrating the interperiosteo-dural concept.

The authors report the clinical, radiological, and histological data of a patient who presented with a tumor of the cavernous space. In addition, they prepared 2 encephalic extremities (4 cavernous spaces) using a special anatomical preparation consisting of an injection of colored neoprene latex followed by a 6-month immersion in a formaldehyde solution enriched with hydrogen peroxide to soften the bone structures (coronal sections) while leaving the fat in the cavernous space intact.

This case report corroborates previously published clinical data and shows that the tumor was a hamartoma comprising mature fat cells associated with vascular proliferation. The tumor developed in the cavernous space, which is an interperiosteo-dural space extending from the sphenoid periosteum (osteoperiosteal layer) to the superior and lateral walls of the cavernous space (encephalic layer). This space represents an anatomical continuum extending from the coccyx to the orbit: the interperiosteo-dural concept. It contains fat tissue that is abundant at the level of the orbit and the epidural spinal space and sparser at the level of the cavernous spaces, as was shown in our anatomical study.

The authors suggest that angiolipomas represent a characteristic tumor that illustrates the interperiosteo-dural concept because they essentially develop in the fat tissue contained in these spaces.

Sellar angiolipomas: two case reports and a review of the literature

Angiolipomas are mesenchymal hamartomas composed of abnormal blood vessels and mature adipose tissue, most commonly found in the subcutaneous tissue of the extremities. Intracranial location is extremely rare, and only five cases have been described in the sellar region. We report on two patients that were initially diagnosed with pituitary adenomas that were postoperatively verified as angiolipomas. Sellar angiolipomas should be considered in the differential diagnosis of pituitary lesions due to the potential catastrophic bleeding during surgery. Preoperative diagnosis is very difficult; however, some MRI characteristics can help make an accurate diagnosis. Adequate MRI sequences should be used in the evaluation of pituitary lesions, as they can help optimize the microsurgical management.

Spinal angiolipoma: case report and literature review

BACKGROUND/OBJECTIVE

Spinal angiolipoma (SAL) is an uncommon clinico-pathological entity.

DESIGN

Single case report.

METHODS

Retrospective data analysis.

FINDINGS

An obese woman with a 1-year history of progressive spastic paraparesis and acute deterioration underwent magnetic resonance imaging of the thoracic spine, the results of which suggested a tumor compressing the thoracic spinal cord. The histopathological examination of the completely resected tumor revealed an epidural angiolipoma.

CONCLUSIONS

This case report offers a reminder that SAL should be considered in the differential diagnosis of long-standing, slowly progressive paraparesis. It remains unclear whether an increased body mass index might be a contributing factor to the development of SAL.

Intracranial angiolipoma as cause of subarachnoid haemorrhage. Case report and review of the literature

A 33-year-old female with a longstanding history of seizures was admitted to our hospital with subarachnoid haemorrhage (SAH). Computed tomography (CT), magnetic resonance imaging (MRI) and digital subtraction angiography (DSA) depicted a vascular fat-containing lesion overlying a right frontal cortical polymicrogyria. The diagnosis of angiolipoma was established. Conservatory management was undertaken with full recovery. She has been followed for 5 years since, with neither re-bleeding nor morphologic change of the lesion. This is a rare intracranial lesion, with only 11 intracranial angiolipomas published in the literature, and is the first case reported which is associated with SAH caused by this lesion.

Angiolipomas of the central nervous system

Angiolipomas are neoplasms composed of mature adipocytes admixed with abnormal vascular elements. They are most commonly found in the subcutaneous tissue of the trunk and extremities, but other sites have been reported. The craniospinal axis is an uncommon but significant site. An extensive review of the literature is conducted. We summarize 94 cases of angiolipomas in the central nervous system (CNS) in 92 patients, including five in our own series, to highlight the most prominent features of these tumors. The increasing number of cases of CNS angiolipoma in the era of magnetic resonance imaging raises the question of the rarity of these lesions.

Diagnostic and microsurgical presentation of intracranial angiolipomas. Case report and review of the literature

Angiolipomas (ALs) are hamartomas composed of abnormally differentiated vessels and mature adipose tissue. Although they are most commonly found in peripheral tissues, ALs sometimes grow in the spinal epidural space. Intracranial ALs (ICALs) are rare: only seven cases have been reported in the literature. The authors describe the case of a 70-year-old woman who presented with ocular symptoms from a clinically and radiologically progressing parasellar ICAL. The radiological as well as the microsurgical findings are illustrated and compared with the seven previously published cases. The most frequent location of ALs is the skull base, especially the parasellar region. Other ICALs were diagnosed as components of cerebral arteriovenous malformations and were not symptomatic by themselves. Neuroradiological studies of ICALs usually demonstrate the characteristics of both adipose and vascular tissues. However, a review of the literature shows that the diagnosis had not been suspected preoperatively in any of the cases. Operative descriptions emphasize that most neurosurgeons were caught off guard by the profuse bleeding and the unusual relationship of this unexpected lesion to the cavernous sinus, so that removal was rarely complete. The authors conclude that preoperative diagnosis of ICALs is achievable based on magnetic resonance analysis, which should help optimize the microsurgical management of these lesions.

Primary epithelioid hemangioendothelioma of the brain

Epithelioid hemangioendothelioma is an uncommon form of endothelial neoplasm, one of intermediate-grade malignancy and relatively favorable prognosis. Herein we report the third and fourth cases described in the central nervous system and compare their clinical and pathologic properties with those arising at systemic sites. Both patients presented with signs and symptoms of a mass lesion with seizures present in both cases. Imaging studies revealed well-demarcated mass lesions with surrounding edema. Gross total removal was accomplished surgically in both cases One case was partially cystic and nodular; the other was firm, focally gritty, and cartilaginous in appearance. Histologically they were identical to hemangioendotheliomas of other locales: multinodular neoplasms with regional variation in cellularity, cords and clusters of epithelioid cells with variable attempts at lumen formation, and spindled cells associated with a fibromyxoid matrix. Immunohistochemical stains confirmed the endothelial natures of the cells. These cases and those previously reported were treated with surgical excision. The few patients described have ranged in age from infants to older adults. Some patients have had residual neurologic defects, but no deaths due to tumor have been reported.