Abstract Details

Title Cerebral Angiolipoma of the Parietal Region Presenting as Olfactory Hallucinations

Topic General Neurology

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-052

Objective NA

Background Angiolipomas are benign tumors of mesenchymal origin typically found in the subcutaneous tissue of the extremities. CNS involvement is rare, with most cases found in the spinal extradural space^1-18. Intracranial angiolipomas are exceedingly rare and typically located in the sellar-parasellar region. We present a rare and unusual case of a cerebral angiolipoma located in the right parietal region.

Design/Methods Patient is a 46 year old female, BRCA+, with 2 year history of olfactory hallucinations occurring for 1-2 minutes, with spells in clusters lasting several hours. She also reported headaches related to her menstrual period and visual disturbances, difficult for her to describe. On examination, multiple raised areas were noted involving the skull bilaterally, the most prominent over the right parieto-occipital region. Neurological exam was normal. Contrast enhanced brain MRI revealed a subtly enhancing extra-axial mass adjacent to the right parietotemporal calvarium, hyperintense in all sequences with punctuate areas of hypointensity intermingled. The mass attenuated on fat saturation with serpiginous intermingled signal suggesting vascular channels. A pituitary mass was also noted. EEG revealed slowing and epileptiform discharges from the right temporal region. She was placed on levetiracetam with resolution of her olfactory hallucinations. Patient underwent surgical excision of the parietal mass, and a year later, of the pituitary mass.

Results Histopathology revealed the lesion to be composed of mature lobulated adipose tissue with proliferations of connective tissue fibers and numerous thin-walled vessels. She remains seizure free and is off levetiracetam. Her BRCA+ status may be unrelated to the tumors noted here, but this status has been shown to have an association with gliomas¹⁹.

Conclusions Angiolipomas are rare in the brain parenchyma. We present a rare case of intracranial angiolipoma involving in the parietal lobe. Angiolipomas have a distinctive appearance on MRI, with fat suppression sequences playing an important role in the differential diagnosis.

Authors/Disclosures
Madhureeta Achari, MD, FAAN (Integrated Neurology PA) PRESENTER	Dr. Achari has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for McKinney-Taylor.
Cesar Escamilla Ocanas	Mr. Escamilla Ocanas has nothing to disclose.
	No disclosure on file
	No disclosure on file

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