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The Natural History of Pediatric Cerebellopontine Angle Lipomas
Ruth K Mizu1, Benjamin D Lovin2, Caitlin M Coviello2
1Baylor College of Medicine, Houston, Texas.
Insights
Pediatric cerebellopontine angle (CPA) lipomas are rare. Most children present with headaches and hearing loss, but symptoms and tumor size typically remain stable over time, suggesting serial MRI is a safe management approach.
Area of Science:
- Pediatric Neurology
- Skull Base Surgery
- Neuro-oncology
Background:
- Cerebellopontine angle (CPA) lipomas are rare, benign tumors.
- Understanding their natural history in pediatric patients is crucial for management.
Purpose of the Study:
- To describe the clinical presentation, natural history, and outcomes of pediatric CPA lipomas.
- To inform management strategies for this rare condition.
Main Methods:
- Retrospective review of pediatric patients diagnosed with CPA lipoma.
- Data collection included clinical symptoms, tumor size, and radiographic changes over time.
- Follow-up duration averaged over 5 years.
Main Results:
- Six pediatric patients were identified with CPA lipomas.
- Headaches and sensorineural hearing loss (SNHL) were the most common symptoms.
- No significant tumor growth or symptom progression was observed in most patients during follow-up.
Conclusions:
- Pediatric CPA lipomas are rare lateral skull base tumors.
- While SNHL and tumor growth can occur, most cases show stability.
- Serial MRI monitoring is a safe initial management strategy.
Objective:
To present a series of pediatric patients with cerebellopontine angle (CPA) lipomas in order to understand their natural history and facilitate management recommendations.
Patients:
Pediatric patients with a diagnosis of CPA lipoma.
Interventions:
Clinical data collected from a single tertiary care center between January 2000 and August 2022.
Main Outcome Measures:
Data related to symptom evolution and tumor growth during follow-up.
Results:
Six patients were identified from a single institution. Average age at presentation was 8.5 years of age (range, 3.1-14.5 years). The most common presenting symptoms were headaches (63%) followed by sensorineural hearing loss (SNHL) (38%). Average tumor size was 10.8 mm (range, 5.8-18 mm). Average duration of clinic and radiographic follow-up were 61 months (range, 16.9-146.1 months) and 52 months (range, 8.7-133.2 months), respectively. Other than 1 patient who experienced worsening asymmetric SNHL, no patient experienced significant changes in symptoms or tumor growth throughout follow-up. On most recent imaging, the average tumor size was 11.3 mm (range, 7-21 mm), which was not statistically different from initial imaging (p = 0.518).
Conclusions:
Pediatric CPA lipomas represent a rare entity of lateral skull base tumors. Most patients present with headaches and SNHL in the adolescent age. While progression of SNHL and tumor growth is possible, most patients do not appear to demonstrate worsening symptoms or tumor growth throughout follow-up. As such, initial management with serial MRI appears to be a safe strategy.
