Multifocal cerebellar liponeurocytoma

A 42-year-old man presented with a 3-year history of headache. Neurologic examination was unremarkable. Brain MRI showed multiple peripheral cerebellar nodules, some containing fat (figure). Biopsy revealed neurocytic cancer cells scattered with mature fat tissue. The approach was conservative with serial imaging follow-up. Cerebellar liponeurocytoma is a rare tumor classified as grade II by the World Health Organization,[1] now considered a clinicopathologic entity distinct from medulloblastoma.1 It is almost always solitary and almost always cerebellar. The clear multifocality of the MRI findings makes this case unusual.2