Calcified intracranial lipoma in the temporal lobe convexity - A report of unusual manifestations of a rare disease with a brief review of literature

Intracranial lipomas are rare congenital malformations that account for approximately 0.1 to 1.3 percent of all intracranial lesions/tumors. They are believed to develop due to an abnormal differentiation of “meninx primitiva,” the embryonic precursor of leptomeninges. Intracranial lipomas are usually located in the midline in the pericallosal location and lipomas away from the midline are unusual. We report a case of an 18-year-old male who had been on anti-epileptic therapy for 5 years for a seizure disorder, but denied having undergone any prior imaging evaluation. Imaging studies of brain using CT and MRI revealed an extensively calcified lipoma in the left temporal lobe convexity region. The published literature on temporal lobe lipomas and those with calcification are both infrequent, therefore our report adds to the existing literature on this extremely rare entity. We inform our readers about a novel “gene expression impairment” concept recently proposed to be the etiology in these patients. Further, we enumerate the rare but reported complication of rupture of this malformation, to increase awareness and alert physicians of its possibility, especially for patients who are managed solely by clinical and imaging surveillance. We also highlight the advancements of microsurgical dissection for better prognosis in such cases.