Cerebellar Liponeurocytoma
A middle aged lady presented to OPD with history of headache and diplopia of 6 weeks that was progressive. On examination she had 6th nerve palsy and positive cerebellar signs.
CT Scan brain showed Mixed density Cerebellar SOL with mild distortion of fourth ventricle and moderate Hydrocephalus.
MRI brain showed mixed intensity Right cerebellar SOL with mass effect.
MRI Spectroscopy of lesion showed high lipid peak with high Choline peak.
Posterior Fossa Retrosigmoid approach was used and well demarcated neoplastic lesion was excised with gross total excision. Per operateive impression of senior surgeon having vast experience in posterior fossa surgeries, was desmoplastic Medulloblastoma.
Post operative course was uneventful. Histopathology report proved to be Liponeurocytoma.
Cerebellar liponeurocytoma is a rare tumor of the central nervous system occurring mainly in the posterior fossa, which shows neuronal and variable astrocytic differentiation with foci of lipomatous differentiation. Liponeurocytoma develops in adult patients and is defined in the World Health Organization classification of 2016 as a rare benign grade II tumor.
They show a different genetic pathway compared to central neurocytomas and medulloblastomas. Surgery is the primary therapy of choice. Adjuvant radiotherapy seems to be sufficient to avoid a tumor recurrence for incomplete resection.
