Hosting 728 files, 2951 images, and 4 contributors.

Random Case

Arteriovenous Malformation
Joseph Junewick, MD FACR
over 9 years ago
Enter A Workflow
Standard2   Academic2

Please choose a workflow. A standard workflow allows you to browse the repository with full case detail; the academic workflow allows you to browse the repository with limited case detail revealed. Double click on the images to launch image viewer.

ARSt Case Repository

Cholesterol Granuloma

Case Detail

Anatomy: Brain-Spine
Joseph Junewick, MD FACR
Diagnostic Category: Developmental or Congenital
Created: over 9 years ago
Updated: over 9 years ago
Tags: PEDS
Modality/Study Types: CT MR
Adobe32 PDF Imagej32 ImageJA


17 year old male with headache.

Case Images


Cholesterol Granuloma – Petrous Apex


CT – Smoothly marginated expansile lesion of the left petrous apex isodense to brain.

MR – T1 and T2 hyperintense, non-enhancing lesion; no intraaxial extension.


Cholesterol granuloma of the petrous apex is a common entity. Cholesterol granuloma grows slowly in the petrous apex until it produces hearing loss, tinnitus, vertigo, and/or facial twitching. Cholesterol granuloma can be treated by drainage and permanent fistulization. Preoperative recognition by CT is important for planning proper treatment. Differential diagnosis includes congenital (asymmetric fatty marrow, cholesteatoma), infection (apical petrositis – Gradinigo syndrome), obstructive process (effusion, mucocele, cholesterol granuloma), benign tumor (meningioma, schwannoma), malignant tumor (chordoma, osteosarcoma, chondrosarcoma, Langerhans histiocytosis).


Lo WW, Solti-Bohman LG, Brackmann DE et al. Cholesterol granuloma of the petrous apex: CT diagnosis. Radiology (1984); 153: 705-711.

Corporate Office: 616.363.7272, 3264 North Evergreen Drive, Grand Rapids, MI 49525

Spectrum Health Helen Devos Childrens Hospital GE HealthCare