Case Report
Volume 13 Issue 5 - 2021
Lipoma of Sylvian Fissure: Simple Pathology in Complex Location
Shashank Aroor1*, George C Vilanilam1, Mathew Abraham1, Deepthi H2 and Ranjith Rangnekar1
1Department of Neurosurgery, Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, India
2Department of Pathology, Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, India
*Corresponding Author: Shashank Aroor, Neurosurgery Chief Resident, Department of Neurosurgery, Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum, India.
Received: March 13, 2021; Published: April 09, 2021




Abstract

Background: Lipoma of Sylvian fissure is a rare lesion. When seizure is intractable surgical excision is indicated. Here we are presenting a case of Sylvian fissure lipoma and the surgical difficulties encountered along with the review of literature.

Case Description: Refractory seizure in a 28 year old male was evaluated. Head computed tomography revealed hypodense lesion of fat attenuation in right Sylvian fissure. On magnetic resonance imaging lesion was hyperintense on both T1 and T2 weighted images with complete suppression on T1 weighted fat suppressed image. Radiological impression was that of lipoma. Standard right pterional craniotomy was performed. Lesion was seen in the Sylvian fissure splaying the inferior frontal gyrus and superior temporal gyrus. Major vessels were seen traversing the lesion. With meticulous dissection near total excision of the lesion was done. Frozen and final histopathological examination was confirmative of lipoma. There was minimal residual lesion seen as calcification on imaging. Post operatively patient was followed up for 6 months with decrease in seizure frequency without any deficit.

Conclusion: Our case report and literature supports the fact that the surgical excision of Sylvian fissure lipoma is extremely difficult and no attempt should be made for complete excision of the lesion. Even now in the era of microsurgery, Sylvian fissure should always be dealt cautiously.

 

Keywords: Lipoma; Seizure; Sylvian Fissure; Tumor; Intracranial Benign Lesions; Epilepsy; Microneurosurgery

References

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Citation: Shashank Aroor., et al. “Lipoma of Sylvian Fissure: Simple Pathology in Complex Location”. EC Neurology 13.5 (2021): 14-20.

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