A rare presentation of Quadrigeminal cistern (tectal plate) lipoma with visual hallucinations in a patient of schizophrenia.

BACKGROUND: Intracranial lipomas are very rare congenital lesions and are usually asymptomatic. They can be found at any age incidentally whenever the brain imaging is done due to some other reason. The most acceptable theory of occurrence of these lipomas is abnormal persistence and maldifferentiation of the meninx primitiva (subarachnoid precursor), which accounts for the subarachnoid location, associated parenchymal anomalies, and traversing structures of intracranial lipomas. Schizophrenia is one of the common psychiatric disorder characterised by significant alterations in perception, thoughts, mood, and behaviour. Hallucination is one of the common symptom of schizophrenia in which any of the five senses may be affected by hallucinatory experiences. The most common hallucinations, however, are auditory, with voices that are often threatening, obscene, accusatory, or insulting. Visual hallucinations are also common but tactile, olfactory, and gustatory hallucinations are unusual; their presence should prompt the clinician to consider the possibility of an underlying medical or neurological disorder that is causing the entire syndrome. Presenting is a case of 39 year old female patient of schizophrenia who presented with visual hallucinations since 1.5 years and brain imaging showed Quadrigeminal cistern (tectal plate) lipoma. RESULT: In this case, we hypothesised that psychotic symptoms were due to presence of lipoma, however surgical removal of lipoma was not planned due to the absence of any compressive effect in the surrounding tissue. Hence more studies are needed.