title: Aggressiveness in cholesterol granuloma of the temporal bone may be determined by the vigor of its blood source.
abstract: OBJECTIVE
  Recently, it has been proposed that the aggressive behavior of cholesterol granuloma (CG) of the petrous apex is explained by its proximity to the richly vascular marrow of the petroclival junction. Most CGs of the lateral temporal bone are indolent. The purpose of the present study is to examine the factors responsible for atypical aggressive behavior in mastoid CG.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  : Tertiary academic practice.
  
  
  METHODS
  Four patients with atypically aggressive CG of the mastoid.
  
  
  RESULTS
  In each case, the CG abutted a rich blood source: the sigmoid sinus, carotid artery, a large dural vein, or a rich deposit of vascular marrow in the mastoid tip.
  
  
  CONCLUSIONS
  These observations lend further support to the theory that aggressiveness of CG is sustained by a robust source of ongoing hemorrhage.
authors.affiliation: Department of Otolaryngology, University of Tuebingen, Germany.
authors.forename: Markus H F
authors.initials: MH
authors.lastname: Pfister
authors.forename: Robert K
authors.initials: RK
authors.lastname: Jackler
authors.forename: Larisa
authors.initials: L
authors.lastname: Kunda
mesh_terms: D000368:Aged; D002784:Cholesterol / Q000378:metabolism*; D018450:Disease Progression; D005260:Female; D015745:Granuloma, Foreign-Body / Q000097:blood / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008416:Mastoid / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013701:Temporal Bone / Q000473:pathology*
chemical_list: D002784:Cholesterol