Cerebellar liponeurocytomas were recognized in the 2000 WHO 3rd edition of CNS tumors as a distinct grade I pathological entity, a tumor with a more favorable prognosis than medulloblastoma. But reports of long-term recurrences and some possible aggressive behavior led to an upgrade on the latest WHO 4th edition of CNS tumors. The case of a 64-year-old female patient is reported in this paper. More than 30 cases of this lately recognized pathological entity have been reported to date. The diagnostic, radiological, and pathological features associated with this tumor are discussed through a literature review. 1. Introduction The cerebellar liponeurocytoma was first included in the 2000 World Health Organisation’s (WHO) 3rd edition of Central Nervous System (CNS) tumors’ classification as a separate grade I entity. Thanks to a better recognition and longer follow-up, evidences of a possible tumor recurrence were growing. Rates of recurrences were estimated to 60% during follow-up, with some cases presenting even an aggressive behavior [1–3]. This way, the cerebellar liponeurocytoma was upgraded II on the 2007 WHO’s 4th edition of CNS tumors’ classification. Through this case report we reviewed the literature for a better understanding of this pathology and the controversy around, with a listing of published cases of cerebellar liponeurocytoma. 2. A Case Report A 64-year-old woman, with a 10-year history of Parkinson’s disease, was admitted to our department for a 7-month clinical course of progressive worsening, right-sided weakness, and signs of increased intracranial pressure. On examination, her consciousness was clear, and, beside the Parkinson’s related tremor, she had a mild right hemiparesia (3/5) with a right Babinski sign and hyperreflexia on the right side. Ocular investigations showed bilateral papilledema and horizontal nystagmus. MRI scan showed a 60 × 40 × 42？mm heterogeneous, enhancing lesion of the right cerebellum extending to the CPA (cerebellopontine angle), causing mass effect and mild hydrocephalous. On T1-weighted images (Figure 1(a)) the mass was iso-intense to brain tissue, with sparse, hyperintense areas that turned hypointense on FAT-SAT sequences (Figure 1(b), arrow). Figure 1: MRI of the brain in sagittal T1 (a), axial fat sat sequence (b), and axial T1 with gadolinium, respectively (c). Note the fat component (arrows in (a) and (c)) that turns hypointense after fat exclusion (arrow in (b)). Irregular enhancement was noted after gadolinium administration (Figure 1(c)). There was no associated edema. The patient underwent
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