Congenital cholesteatoma, epidermoid or epidermoid cyst
Definitions
PA cholesteatoma (epidermoid): Ectopic ectodermal tissue in petrous bone ultimately gives rise to expansile, cystic mass lined by stratified squamous epithelium and filled with keratinous debris
IMAGING
General Features
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Maxwell AK et al: Congenital cholesteatoma of the sphenoid, occipital, and temporal bones: 54-year follow up. Otol Neurotol. 41(5):e593-6, 2020
Casazza GC et al: Primary petrous apex epidermoids with skull base erosion. Otol Neurotol. 40(5):e556-61, 2019
Orhan KS et al: Endoscope-assisted surgery for petrous bone cholesteatoma with hearing preservation. J Int Adv Otol. 15(3):391-5, 2019
Sharma SC et al: Petrous bone cholesteatoma: radical excision with an endeavour for hearing preservation. Indian J Otolaryngol Head Neck Surg. 71(Suppl 2):1572-9, 2019
Iannella G et al: Giant petrous bone cholesteatoma: combined microscopic surgery and an adjuvant endoscopic approach. J Neurol Surg Rep. 77(1):e46-9, 2016
MacKeith SA et al: Recurrent aseptic meningitis as a rare but important presentation of congenital petrous apex cholesteatoma: the value of appropriate imaging. BMJ Case Rep. 2014
Chapman PR et al: Petrous apex lesions: pictorial review. AJR Am J Roentgenol. 196(3 Suppl):WS26-37 Quiz S40-3, 2011
De Foer B et al: Diffusion-weighted magnetic resonance imaging of the temporal bone. Neuroradiology. 52(9):785-807, 2010
Connor SE et al: Imaging of the petrous apex: a pictorial review. Br J Radiol. 81(965):427-35, 2008
Moffat D et al: Petrous temporal bone cholesteatoma: a new classification and long-term surgical outcomes. Skull Base. 18(2):107-15, 2008
Kojima H et al: Congenital cholesteatoma clinical features and surgical results. Am J Otolaryngol. 27(5):299-305, 2006
Mattox DE: Endoscopy-assisted surgery of the petrous apex. Otolaryngol Head Neck Surg. 130(2):229-41, 2004
Profant M et al: Petrous apex cholesteatoma. Acta Otolaryngol. 120(2):164-7, 2000
Chang P et al: Imaging destructive lesions of the petrous apex. Laryngoscope. 108(4 Pt 1):599-604, 1998
Mafee MF: MRI and CT in the evaluation of acquired and congenital cholesteatomas of the temporal bone. J Otolaryngol. 22(4):239-48, 1993
Atlas MD et al: Petrous apex cholesteatoma: diagnostic and treatment dilemmas. Laryngoscope. 102(12 Pt 1):1363-8, 1992
Ishii K et al: Middle ear cholesteatoma extending into the petrous apex: evaluation by CT and MR imaging. AJNR Am J Neuroradiol. 12(4):719-24, 1991
Glasscock ME 3rd et al: Petrous apex cholesteatoma. Otolaryngol Clin North Am. 22(5):981-1002, 1989
Rosenberg RA et al: Cholesteatoma vs. cholesterol granuloma of the petrous apex. Otolaryngol Head Neck Surg. 94(3):322-7, 1986
Horn KL et al: Congenital cholesteatoma of the petrous pyramid. Arch Otolaryngol. 111(9):621-2, 1985
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Petrous apex (PA) cholesteatoma (PA-Chol)
Synonyms
Congenital cholesteatoma, epidermoid or epidermoid cyst
Definitions
PA cholesteatoma (epidermoid): Ectopic ectodermal tissue in petrous bone ultimately gives rise to expansile, cystic mass lined by stratified squamous epithelium and filled with keratinous debris
IMAGING
General Features
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Maxwell AK et al: Congenital cholesteatoma of the sphenoid, occipital, and temporal bones: 54-year follow up. Otol Neurotol. 41(5):e593-6, 2020
Casazza GC et al: Primary petrous apex epidermoids with skull base erosion. Otol Neurotol. 40(5):e556-61, 2019
Orhan KS et al: Endoscope-assisted surgery for petrous bone cholesteatoma with hearing preservation. J Int Adv Otol. 15(3):391-5, 2019
Sharma SC et al: Petrous bone cholesteatoma: radical excision with an endeavour for hearing preservation. Indian J Otolaryngol Head Neck Surg. 71(Suppl 2):1572-9, 2019
Iannella G et al: Giant petrous bone cholesteatoma: combined microscopic surgery and an adjuvant endoscopic approach. J Neurol Surg Rep. 77(1):e46-9, 2016
MacKeith SA et al: Recurrent aseptic meningitis as a rare but important presentation of congenital petrous apex cholesteatoma: the value of appropriate imaging. BMJ Case Rep. 2014
Chapman PR et al: Petrous apex lesions: pictorial review. AJR Am J Roentgenol. 196(3 Suppl):WS26-37 Quiz S40-3, 2011
De Foer B et al: Diffusion-weighted magnetic resonance imaging of the temporal bone. Neuroradiology. 52(9):785-807, 2010
Connor SE et al: Imaging of the petrous apex: a pictorial review. Br J Radiol. 81(965):427-35, 2008
Moffat D et al: Petrous temporal bone cholesteatoma: a new classification and long-term surgical outcomes. Skull Base. 18(2):107-15, 2008
Kojima H et al: Congenital cholesteatoma clinical features and surgical results. Am J Otolaryngol. 27(5):299-305, 2006
Mattox DE: Endoscopy-assisted surgery of the petrous apex. Otolaryngol Head Neck Surg. 130(2):229-41, 2004
Profant M et al: Petrous apex cholesteatoma. Acta Otolaryngol. 120(2):164-7, 2000
Chang P et al: Imaging destructive lesions of the petrous apex. Laryngoscope. 108(4 Pt 1):599-604, 1998
Mafee MF: MRI and CT in the evaluation of acquired and congenital cholesteatomas of the temporal bone. J Otolaryngol. 22(4):239-48, 1993
Atlas MD et al: Petrous apex cholesteatoma: diagnostic and treatment dilemmas. Laryngoscope. 102(12 Pt 1):1363-8, 1992
Ishii K et al: Middle ear cholesteatoma extending into the petrous apex: evaluation by CT and MR imaging. AJNR Am J Neuroradiol. 12(4):719-24, 1991
Glasscock ME 3rd et al: Petrous apex cholesteatoma. Otolaryngol Clin North Am. 22(5):981-1002, 1989
Rosenberg RA et al: Cholesteatoma vs. cholesterol granuloma of the petrous apex. Otolaryngol Head Neck Surg. 94(3):322-7, 1986
Horn KL et al: Congenital cholesteatoma of the petrous pyramid. Arch Otolaryngol. 111(9):621-2, 1985
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