Internal Auditory Canal Lipoma: An Unusual Intracranial Lesion

Background Internal auditory canal (IAC) lipomas are rare intracranial lesions. Consequently, preoperative imaging is essential in differentiating IAC lipomas from more common tumors such as vestibular schwannomas. The hallmark of lipomas on magnetic resonance imaging (MRI) is hyperintensity on T1-weighted images that suppresses on fat-suppressed sequences and does not enhance with gadolinium administration. Case Description The present case describes a 53-year-old woman who was misdiagnosed with a vestibular schwannoma because of the lack of appropriate MRI sequences. Conclusions This case demonstrates the importance of ensuring that both fat-suppressed and non−fat-suppressed T1-weighted pregadolinium images are obtained in the diagnostic process of IAC lesions. It is therefore recommended that imaging centers ensure that such sequences are included in their MRI protocols.