The Natural History of Pediatric Cerebellopontine Angle Lipomas

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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.

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