Lipoma in the Corpus Callosum Presenting with Epileptic Seizures Associated with Expanding Perifocal Edema: A Case Report and Literature Review

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 corpu...

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Main Authors: Michiyasu Fuga, Toshihide Tanaka, Yohei Yamamoto, Yuzuru Hasegawa, Yuichi Murayama, Junko Takahashi-Fujigasaki
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Neurological Medicine
Online Access:http://dx.doi.org/10.1155/2015/520208
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author Michiyasu Fuga
Toshihide Tanaka
Yohei Yamamoto
Yuzuru Hasegawa
Yuichi Murayama
Junko Takahashi-Fujigasaki
author_facet Michiyasu Fuga
Toshihide Tanaka
Yohei Yamamoto
Yuzuru Hasegawa
Yuichi Murayama
Junko Takahashi-Fujigasaki
author_sort Michiyasu Fuga
collection DOAJ
description 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.
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publishDate 2015-01-01
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series Case Reports in Neurological Medicine
spelling doaj-art-a94b39b1ec2f41d3af2831b4cbfc56072025-08-20T02:20:33ZengWileyCase Reports in Neurological Medicine2090-66682090-66762015-01-01201510.1155/2015/520208520208Lipoma in the Corpus Callosum Presenting with Epileptic Seizures Associated with Expanding Perifocal Edema: A Case Report and Literature ReviewMichiyasu Fuga0Toshihide Tanaka1Yohei Yamamoto2Yuzuru Hasegawa3Yuichi Murayama4Junko Takahashi-Fujigasaki5Department of Neurosurgery, Jikei University School of Medicine, Kashiwa Hospital, Chiba, JapanDepartment of Neurosurgery, Jikei University School of Medicine, Kashiwa Hospital, Chiba, JapanDepartment of Neurosurgery, Jikei University School of Medicine, Kashiwa Hospital, Chiba, JapanDepartment of Neurosurgery, Jikei University School of Medicine, Kashiwa Hospital, Chiba, JapanDepartment of Neurosurgery, Jikei University School of Medicine, Tokyo, JapanDivision of Neuropathology, Jikei University School of Medicine, Tokyo, JapanThis 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.http://dx.doi.org/10.1155/2015/520208
spellingShingle Michiyasu Fuga
Toshihide Tanaka
Yohei Yamamoto
Yuzuru Hasegawa
Yuichi Murayama
Junko Takahashi-Fujigasaki
Lipoma in the Corpus Callosum Presenting with Epileptic Seizures Associated with Expanding Perifocal Edema: A Case Report and Literature Review
Case Reports in Neurological Medicine
title Lipoma in the Corpus Callosum Presenting with Epileptic Seizures Associated with Expanding Perifocal Edema: A Case Report and Literature Review
title_full Lipoma in the Corpus Callosum Presenting with Epileptic Seizures Associated with Expanding Perifocal Edema: A Case Report and Literature Review
title_fullStr Lipoma in the Corpus Callosum Presenting with Epileptic Seizures Associated with Expanding Perifocal Edema: A Case Report and Literature Review
title_full_unstemmed Lipoma in the Corpus Callosum Presenting with Epileptic Seizures Associated with Expanding Perifocal Edema: A Case Report and Literature Review
title_short Lipoma in the Corpus Callosum Presenting with Epileptic Seizures Associated with Expanding Perifocal Edema: A Case Report and Literature Review
title_sort lipoma in the corpus callosum presenting with epileptic seizures associated with expanding perifocal edema a case report and literature review
url http://dx.doi.org/10.1155/2015/520208
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