title: Atypical radiographic features of skull base cholesterol granuloma.
abstract: Cholesterol granulomas (CGs) are the most common benign lesions of the petrous apex (PA) and have distinct computed tomography (CT) and magnetic resonance imaging (MRI) characteristics. On CT, CGs of the PA (PACG) present as expansile lesions with erosion of bony trabeculae. MRI shows a hyperintense lesion on T1-and T2-weighted images and do not enhance with gadolinium. The objective is to describe the radiographic features of CGs of the skull base that do not arise from the PA. This study is a retrospective review. Three patients were operated on for suspected recurrent endolymphatic sac tumor, intracranial cholesteatoma, and recurrent sphenoid wing meningioma based on CT and MRI findings. Pathology results were consistent with CG in all three cases. All patients had bone erosion on CT. These skull base CGs did not demonstrate similar MRI features. These lesions were hyperintense, iso-to-hyperintense, and hypointense on T1-weighted MRI, respectively. These CGs were hyperintense in two cases and iso-to-hyperintense in one case on T2-weighted MRI. These lesions either demonstrated central or rim enhancement after gadolinium administration. Skull base CGs that do not arise from the PA demonstrate a broad spectrum of radiographic characteristics on MRI that are not typical of PACG.
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 NW 14th Street, 5th Floor, Miami, FL, 33136, USA.
authors.forename: Christine T
authors.initials: CT
authors.lastname: Dinh
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 NW 14th Street, 5th Floor, Miami, FL, 33136, USA.
authors.forename: Stefania
authors.initials: S
authors.lastname: Goncalves
authors.affiliation: Department of Neurosurgery, University of Miami Miller School of Medicine, 1611 NW 12th Avenue, Suite W279, Miami, FL, 33136, USA.
authors.forename: Rita
authors.initials: R
authors.lastname: Bhatia
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 NW 14th Street, 5th Floor, Miami, FL, 33136, USA.
authors.forename: Kim
authors.initials: K
authors.lastname: Truong
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 NW 14th Street, 5th Floor, Miami, FL, 33136, USA.
authors.forename: Fred
authors.initials: F
authors.lastname: Telischi
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 NW 14th Street, 5th Floor, Miami, FL, 33136, USA.
authors.forename: Simon
authors.initials: S
authors.lastname: Angeli
authors.affiliation: Department of Neurosurgery, University of Miami Miller School of Medicine, 1611 NW 12th Avenue, Suite W279, Miami, FL, 33136, USA.
authors.forename: Jacques
authors.initials: J
authors.lastname: Morcos
authors.affiliation: Department of Otolaryngology, University of Miami Miller School of Medicine, 1120 NW 14th Street, 5th Floor, Miami, FL, 33136, USA. aeshraghi@med.miami.edu.
authors.forename: Adrien A
authors.initials: AA
authors.lastname: Eshraghi
mesh_terms: D000328:Adult; D002784:Cholesterol; D005260:Female; D015745:Granuloma, Foreign-Body / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019291:Skull Base / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
chemical_list: D002784:Cholesterol
keywords: CT; Cholesterol granuloma; MRI; Petrous apex; Skull base