title: Lipoma in the Corpus Callosum Presenting with Epileptic Seizures Associated with Expanding Perifocal Edema: A Case Report and Literature Review.
abstract: This report describes a rare case of a patient with lipoma presenting with epileptic seizures associated with expanding perifocal edema. The patient was a 48-year-old man who presented with loss of consciousness and convulsions. Magnetic resonance imaging (MRI) revealed a calcified mass in the corpus callosum with perifocal edema causing mass effect. An interhemispheric approach was used to biopsy the mass lesion. Histological examination revealed typical adipose cells, along with hamartomatous components. These components contained neurofilament and S-100-positive structures showing marked calcification. Fibrous cells immunoreactive for α-smooth muscle actin and epithelial membrane antigen proliferated with focal granulomatous inflammatory changes. MIB-1 index was approximately 5% in immature cells observed in granulomatous areas. We thus suspected a coexisting neoplastic component. The residual lesion persisted in a dormant state for 2 years following biopsy. Surgical resection of a lipoma is extremely difficult and potentially dangerous. However, in the present case, the lesion was accompanied by atypical, expanding, and perifocal edema. Surgical treatment was inevitable for the purpose of histological confirmation, considering differential diagnoses such as dermoid, epidermoid, and glioma. In the end, anticonvulsant therapy proved effective for controlling epileptic seizures.
authors.affiliation: Department of Neurosurgery, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan.
authors.forename: Michiyasu
authors.initials: M
authors.lastname: Fuga
authors.affiliation: Department of Neurosurgery, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan.
authors.forename: Toshihide
authors.identifier: 0000-0002-6474-6317
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Neurosurgery, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: Department of Neurosurgery, Jikei University School of Medicine, Kashiwa Hospital, Chiba, Japan.
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: Department of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Murayama
authors.affiliation: Division of Neuropathology, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Takahashi-Fujigasaki