Search :     
Articles » Central nervous system » Lipoma of the corpus callosum

2002-08-09-10 Pericallosal lipoma © Jacquemard




Pericallosal lipoma

François Jacquemard MD*, Bettina Bessières, MD**, Catherine Fallet, MD**, Luc Gourand, MD*, Fernand Daffos MD*, Fernando Heredia MD***

Institut de Puériculture de Paris,* Service de medecine foetale, **Service de foetopathologie, ***Women"s Health Alliance, Nashville, Tennessee


Case report:

The following are images obtained from a third trimester fetal head:

The images presented show an echogenic, well-circumscribed mass in direct relation with the corpus callosum and the lateral ventricles. Mild ventriculomegaly was also noted.

 Pictures from the pathological brain examination show a yellow mass of the corpus callosum which extends to the lateral ventricles

Hystological exmination show that this mass was composed by fatty tissue, which confirmed the diagnosis of Lipoma of the corpus callosum or pericallosal lipoma.


Definition: Pericallosal lipoma is a fatty tumor of the corpus callosum that can extend to the choroidal areas.

Incidence: Found in one of 0.04-0.4:10,000 autopsies.

Etiology: The pathogenesis of a pericallosal lipoma is considered to be the result of an abnormal resorption of the primitive meninges. Usually, this resorption occurs between the eighth and the 10th week of development. When the primitive meninge persists longer, instead of being resorbed, it differentiates into lipomatous tissue. Such lipoma may develop in all the cerebral cisternae, but they are much more frequent in the area of the corpus callosum where it interferes with its normal growth between the 11th and 20th weeks. Therefore, anomalies of the development of the corpus callosum (complete or partial agenesis, hypoplasia) almost always coexist. The degree of anomaly seems to be in relation with the size and location of the lipoma.

Diagnosis: Easily found in all patients with this anomaly.

Two morphologic types of pericallosal lipoma have been described on the basis of MR imaging findings in adults and children:

  • One is a tubulo-nodular type, appearing round and measuring >2 cm. It is usually anterior and associated with extensive callosal and possibly fronto-facial anomalies.
  • The second type is curvilinear: thin, elongated, measuring <1 cm in diameter and usually more posterior. The corpus callosum is only mildly hypoplastic. The tubulo-nodular type is much more common.

On obstetric sonograms, the lipoma is best visualized on an image obtained slightly above the image that is intended to measure the biparietal diameter. The aspect of a pericallosal lipoma is characteristic: a nodular or curvilinear mass within the interhemispheric fissure. A lipoma is always an echogenic mass. The echogenicity of the lipoma is very similar to that of the parietal bone. The margins are smooth but can be irregular and somewhat spiculated in larger tumors. They can extend towards the frontal lobes and/or towards the choroid plexuses.

The diagnosis of the tubulo-nodular type is easier than the diagnosis of the curvilinear type. Fetal MR imaging may help for the evaluation of the associated anomalies, especially of the frequent callosal anomaly, since he morphology and integrity of the underlying corpus callosum is harder to assess by using sonography.

Fetal MR imaging has been recently performed to further asses this cases in utero. It can confirm the presence of the lipoma (can characterize very well fatty tissue) and also characterize the morphology of the corpus callosum in all cases; it can show the extension of the lipoma in a much better and detailed way than the conventional ultrasound.

Genetic anomalies: Unknown.

Differential diagnosis:

  • Hemorrhages
  • Teratoma
  • Craniopharingioma.
  • Primitive neuroectodermal tumors 

Less likely, but also in the differential diagnosis list are:

  • Glioblastoma multiform
  • Medulloblastoma
  • Gliomas of the optic bulbs and of the hypothalamus
  • Metastasis of choriocarcinoma
  • Astrocytoma
  • Fetus-in-fetu.

Assdociated anomalies:

The entity is rarely isolated, and the fetal anatomical survey must be as complete as possible to detect all associated malformations.

  • Dysgenesis/agenesis of the corpus callosum and gyration anomalies. Some authors have suggested that these lipomas may be part of specific malformative syndromes.
  • Goldenhar syndrome.
  • Trisomies 13, 15, 18, and 21


Very good prognosis for fetuses with isolated lipoma of the corpus callosum, with normal results in neurological examinations in most of the series. If other anomalies are encountered, the prognosis is variable. Fifty percent of the interhemispheric lipomas are associated with seizures starting in the second decade of life. Mental retardation and psychological disorders may develop later in life.


Aside from fetal karyotyping, advisable because of the reported association with aneuploidy, standart prenatal care and delivery should not be altered.

MRI Imaging to complement prenatal sonographic findings is mandatory.

Concerning the tumors growth, little is known. We know fat cells markedly increase in size during infancy. It has been shown that growth of intraspinal lipoma may parallel the postnatal fatty growth of the patients and that, conversely, a diet leading to a reduction of the body fat may determine a decrease in the size of the spinal lipoma. Therefore, it is suggested that patients with intraspinal lipomas be followed up throughout childhood and that their weight be monitored. The same could likely apply to intracranial lipomas; however, this postnatal growth has not been reported until now.




1.    Demaerel P, Van de Gaer P, Wilms G, Baert AL. Interhemispheric lipoma with variable callosal dysgenesis: relationship between embryology, morphology, and symptomatology. Eur Radiol 1996;6:904-909[Medline]

2.    Bork MD, Smeltzer JS, Egan JF, Rodis JF, DiMario Fl Jr, Campbell WA. Prenatal diagnosis of intracranial lipoma associated with agenesis of the corpus callosum. Obstet Gynecol 1996;87:845-848[Medline]

3.    Jeanty P, Zaleski W, Fleischner AC. Prenatal monographic diagnosis of lipoma of the corpus callosum in a fetus with Goldenhar syndrome. Am J Perinat 1991;8:89-90

4.    Milligan G, Meier P. Lipoma and agenesis of the corpus callosum with associated choroid plexus lipomas: in utero diagnosis. J Utrasound Med 1998;8:583-588

5.    Multz MA, Koenigsberg M, Lantos G. US case of the day: lipoma and hypogenesis of the corpus callosum. Radiographics 1996;16:1227-1230[Medline]

6.    Truwit CL, Barkovich AJ. Pathogenesis of intracranial lipoma: an MR study in 42 patients. AJR Am J Roentgenol 1990;155:855-865[Abstract]

7.    Verga P. Lipoma ed osteolipomi della pia madre. Tumori 1929;15:321

8.    Tart RP, Quisling RG. Curvilinear and tubulonodular varieties of lipoma of the corpus callosum: an MR and CT study. J Comput Assist Tomogr 1991;15:805-810[Medline]

9.    Rubinstein D, Youngman V, Hise JH, Damiano TR. Partial development of the corpus callosum. AJNR Am J Neuradiol 1994;15:869-875

10.    Gupta JK, Lilford R. Assessment and management of fetal agenesis of the corpus callosum. Prenat Diagn 1995;15:301-312[Medline]

11.    Revel W, Pons JC, Lelaidier C, et al. MRI of the fetus: a study of 20 cases performed without curarization. Prenat Diagn 1993;13:775-790[Medline]

12.    Hansen PE, Ballesteros MC, Soila K, Garcia L, Howard JM. MRI of the developing human brain. Radiographics 1993;13:21-36[Abstract]

13.    Gastaut H, Regis H, Gastaut JL, Yermenos E, Low MD. Lipomas of the corpus callosum and epilepsy. Neurology 1980;30:132-138[Abstract]

14.    Beltinger C, Saule H. Imaging of lipoma of the corpus callosum and intracranial dermoids in the Goldenhar syndrome. Pediatr Radiol 1988;18:72-73[Medline]

15.    Wainwright H, Bowen R, Radcliffe M. Lipoma of the corpus callosum associated with dysraphic lesions and trisomy 13. Am J Med Genet 1995;57:10-13[Medline]

16.    Knittle J, Timmers K, Ginsberg-Fellner F, Brown RE, Katz DP. The growth of adipose tissue in children and adolescents: cross-sectional and longitudinal studies of adipose cell number and   size. J Clin Invest 1979;63:239-246[Medline]

17.    Pierre-Kahn A, Zerah M, Renier D, et al. Congenital lumbosacral lipomas. Childs Nerv Syst l997;13:298-335

18.    Ickowitza V, Eurina D, Rypensa F,Sonigoa P,Simona I, Davida P, Brunellea F, Avni FE. Prenatal Diagnosis and Postnatal Follow-up of Pericallosal Lipoma: Report of Seven New Cases. American Journal of Neuroradiology 22:767-772

19.    Tae Hoon Kim, Joon Hee Joh, Mi Young Kim, Yang Min Kim, Kwang Soo Han. Fetal Pericallosal Lipoma: US and MR Findings. Korean Journal of Radiology; 2002 June; 3(2):140-143


Help Support :