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21.01.2017 | Original Article - Brain Tumors | Ausgabe 4/2017

Acta Neurochirurgica 4/2017

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

Zeitschrift:
Acta Neurochirurgica > Ausgabe 4/2017
Autoren:
Carlito Lagman, Brittany L. Voth, Lawrance K. Chung, Timothy T. Bui, Seung J. Lee, Natalie E. Barnette, Quinton Gopen, Isaac Yang
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00701-017-3076-5) contains supplementary material, which is available to authorized users.

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.

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Zusatzmaterial
Supplemental Table 1 (DOCX 207 kb)
701_2017_3076_MOESM1_ESM.docx
Literatur
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