A Rare Case Report of Intracranial Angiolipoma in an Adolescent with literature review

Abstract

Background:    Angiolipomas are slow-growing, benign tumors originating from mesenchymal cells, characterized by mature adipocytes and delicate blood vessels. While most angiolipomas occur in subcutaneous tissues, intracranial lesions are exceedingly rare.

Case presentation:  We present the case of a 12-year-old female who presented with seizures, upward eye deviation, and slurred speech. MRI revealed a subpial heterogeneous signal conglomerate with adjacent chronic microhemorrhage in the right lateral sulcus along the superior temporal gyrus. A local reactive cortical atrophy with mild sulcal enlargement was noted, without significant mass effect. An abnormally hyperplastic cortical venous shunt, likely a cavernous angioma, was identified. Additionally, a single atrophic focus was observed in the left frontal lobe. Radiological findings classified the lesion as an "other specified congenital malformation of the circulatory system. She underwent craniotomy and excision of the mass, which, upon histological examination, comprised mature adipocytes and blood vessels, consistent with the diagnosis of intracranial angiolipoma.

Conclusions:       This case highlights the importance of including ICAL in the differential diagnosis of intracranial lipomatous tumors. MRI findings, coupled with histopathological confirmation, are essential for an accurate diagnosis. Surgical resection remains the preferred treatment, though complete removal may be challenging due to vascular involvement.