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

  • Original Article - Brain Tumors
  • Published:
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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.

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Acknowledgements

Carlito Lagman is supported by a Gurtin Skull Base Research Fellowship. Lawrance K. Chung is supported by an AMA foundation Seed Grant and an AΩA Carolyn L. Kuckein Student Research Fellowship. Timothy T. Bui is a recipient of the David Geffen Medical Scholarship. Seung J. Lee is a recipient of the American Academy of Neurology Medical Student Summer Research Scholarship and Short Term Training Project Award. Isaac Yang is partially supported by a Visionary Fund Grant, an Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research UCLA Scholars in Translational Medicine Program Award, the Jason Dessel Memorial Seed Grant, the UCLA Honberger Endowment Brain Tumor Research Seed Grant and the Stop Cancer (US) Research Career Development Award.

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Authors and Affiliations

  1. Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA

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

  2. Department of Radiation Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA

    Isaac Yang

  3. Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA

    Quinton Gopen & Isaac Yang

  4. Jonsson Comprehensive Cancer Center (JCCC), University of California, Los Angeles, Los Angeles, CA, USA

    Isaac Yang

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  7. Quinton Gopen
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  8. Isaac Yang
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Corresponding author

Correspondence to Isaac Yang.

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This study is a systematic analysis and therefore is exempt from Institutional Review Board approval.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; participation in speakers’ bureaus; membership, employment, consultancies, stock of ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Lagman, C., Voth, B.L., Chung, L.K. et al. Evaluating the utility of a scoring system for lipomas of the cerebellopontine angle. Acta Neurochir 159, 739–750 (2017). https://doi.org/10.1007/s00701-017-3076-5

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