Abstract
Objective A case of a skull base cholesterol granuloma (CG) of the squamosal temporal bone. This is the first ever reported case of CG in a well-pneumatized squamous temporal bone. Design Case report and review of the literature. Discussion. CG is a cystic mass typically found in the petrous apex and occasionally in the paranasal sinuses and orbit. Experience with the treatment of these expansile and inflammatory processes has largely been garnered from those occurring in the petrous apex, where they are surgically drained, via a transtympanic, transmastoid, or middle fossa approach. We report a case of cholesterol granuloma situated in the temporal fossa presenting as a temporal mass. The accessible location of this particular lesion made it amenable to total excision, avoiding the need for surgical drainage and possibility for recurrence. Conclusion This case supports the theory of pathogenesis of such lesions typically occurring where pneumatized air spaces interface with bone marrow, in this case, where the reaches of pneumatized cells in the squamous portion of the temporal bone meet diploic bone.
Highlights
First described over 100 years ago, temporal bone cholesterol granuloma (CG) are defined pathologically by the presence of cholesterol crystals surrounded by multinucleated giant cells, round cell infiltration, and hemosiderin-laden macrophages [1].ese expansile lesions of the temporal bone are most often found at the petrous apex or tympanomastoid portions of the temporal bone
“exuberant” pneumatization of the petrous temporal bone allows for direct interaction of air cells with adjacent marrow space. e resulting hemorrhage into the pneumatized petrous apex allows for formation of the CG; this is known as the exposed marrow hypothesis [2]
Cholesterol granulomas are expansile cystic lesions with the potential for osseous erosion that consists of cholesterol crystals within a fibrous capsule [1]
Summary
A case of a skull base cholesterol granuloma (CG) of the squamosal temporal bone. is is the first ever reported case of CG in a well-pneumatized squamous temporal bone. A case of a skull base cholesterol granuloma (CG) of the squamosal temporal bone. Is is the first ever reported case of CG in a well-pneumatized squamous temporal bone. CG is a cystic mass typically found in the petrous apex and occasionally in the paranasal sinuses and orbit. Experience with the treatment of these expansile and inflammatory processes has largely been garnered from those occurring in the petrous apex, where they are surgically drained, via a transtympanic, transmastoid, or middle fossa approach. We report a case of cholesterol granuloma situated in the temporal fossa presenting as a temporal mass. Is case supports the theory of pathogenesis of such lesions typically occurring where pneumatized air spaces interface with bone marrow, in this case, where the reaches of pneumatized cells in the squamous portion of the temporal bone meet diploic bone Conclusion. is case supports the theory of pathogenesis of such lesions typically occurring where pneumatized air spaces interface with bone marrow, in this case, where the reaches of pneumatized cells in the squamous portion of the temporal bone meet diploic bone
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