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Acta Neurochirurgica
Published in: Acta Neurochirurgica 4/2017

01-04-2017 | Original Article - Brain Tumors

Evaluating the utility of a scoring system for lipomas of the cerebellopontine angle

Authors: Carlito Lagman, Brittany L. Voth, Lawrance K. Chung, Timothy T. Bui, Seung J. Lee, Natalie E. Barnette, Quinton Gopen, Isaac Yang

Published in: Acta Neurochirurgica | Issue 4/2017

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Abstract

Background

Cerebellopontine angle (CPA) lipomas are rare, benign, slow-growing masses. Resections are considered in symptomatic patients who are refractory to targeted medical therapies, but at those stages the lipomas have often reached considerable sizes and encompass critical neurovascular structures. The objective of this study is to develop and to evaluate the utility of a scoring system for CPA lipomas. The hypothesis is that CPA lipomas with lower scores are probably best managed with early surgery.

Methods

The PubMed database was searched using relevant terms. Data on patient and lipoma characteristics were extracted and used to design a scoring system. CPA lipomas were stratified by scores with corresponding managements and outcomes analyzed.

Results

One hundred and seventeen patients with CPA lipomas were identified and 40 CPA lipomas were scored. The remaining CPA lipomas were deficient in data and not scored. No lipomas were scored as 1. Score 2 lipomas (n = 12; 30%) most often underwent serial surveillances (n = 5; 41.6%), with the majority of symptoms remaining unimproved (n = 2; 40%). Patients with score 2 CPA lipomas treated with medical therapies (n = 3; 25%) often experienced symptom resolution (n = 2; 66.6%) (p = 0.0499). Patients with score 2 CPA lipomas undergoing surgical resections (n = 3; 25%) all experienced symptom resolution (n = 3; 100%) (p = 0.0499). Score 3 was most common (n = 16; 40%) and these lipomas were often surgically resected (n = 10; 62.5%). The majority of patients with score 3 CPA lipomas having undergone surgical resections (n = 10; 62.5%) experienced symptom improvement (n = 1; 10%) or resolution (n = 4; 40%).

Conclusions

Score 2 CPA lipomas are smaller and would be deemed non-surgical in general practice. However, our data suggest that these lipomas may benefit from either medical therapies or early surgical resections. The advantages of early surgery are maximal resection, decreased surgical morbidity, and improved symptom relief.
Appendix
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Metadata
Title
Evaluating the utility of a scoring system for lipomas of the cerebellopontine angle
Authors
Carlito Lagman
Brittany L. Voth
Lawrance K. Chung
Timothy T. Bui
Seung J. Lee
Natalie E. Barnette
Quinton Gopen
Isaac Yang
Publication date
01-04-2017
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 4/2017
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-017-3076-5

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