A cerebellopontine angle lipoma discovered incidentally in an asymptomatic 17 year old girl during evaluation for trauma is reported from the University of Alabama and Children’s Hospital, Birmingham, AL. The CT had shown a low density nonenhancing 1.5 cm mass in the right cerebellopontine angle. The patient denied hearing loss, tinnitus, facial weakness or other neurologic symptoms. On examination she had a left-sided hearing loss, an audiogram showed left conductive hearing loss, and brainstem auditory evoked potentials were abnormal on the left. MRI was consistent with either an epidermoid or a lipoma. At surgical biopsy which confirmed the diagnosis the mass involved the 7th and 8th as well as portions of the 9th, 10th and 11th cranial nerves and was partially adherent to the brainstem. Surgical removal was not possible and postoperatively the patient made an uneventful recovery. 
COMMENT. The authors found only one other report of this tumor in a child and 17 in adults. They recommend that surgical removal should be avoided if possible because of postoperative cranial nerve injury. A mass with negative CT density and increased signal intensity on T1 and T2 weighted images on MRI should limit the differential diagnosis to lipomas, dermoids, or cholesterol granulomas, according to reports in the literature.