PA-CG: Expansile PA lesion resulting from foreign body giant cell reaction to deposition of cholesterol crystals in apical air cells with fibrosis and vascular proliferation
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
Fieux M et al: Petrous apex cholesterol granuloma revealed by facial palsy. Ann Neurol. 89(2):414-15, 2021
Albakheet N et al: Familial hypercholesterolemia with bilateral cholesterol granuloma: a case series. Int J Surg Case Rep. 62:135-9, 2019
Campion T et al: Imaging of temporal bone inflammations in children: a pictorial review. Neuroradiology. 61(9):959-70, 2019
Stevens SM et al: Long-term symptom-specific outcomes for patients with petrous apex cholesterol granulomas: surgery versus observation. Otol Neurotol. 38(2):253-9, 2017
Sweeney AD et al: The natural history and management of petrous apex cholesterol granulomas. Otol Neurotol. 36(10):1714-9, 2015
Juliano AF et al: Imaging review of the temporal bone: part I. Anatomy and inflammatory and neoplastic processes. Radiology. 269(1):17-33, 2013
Hoa M et al: Petrous apex cholesterol granuloma: maintenance of drainage pathway, the histopathology of surgical management and histopathologic evidence for the exposed marrow theory. Otol Neurotol. 33(6):1059-65, 2012
Caversaccio M et al: Cholesterol granuloma of the petrous apex: benefit of computer-aided surgery. Eur Arch Otorhinolaryngol. 266(1):47-50, 2009
Sanna M et al: Otoneurological management of petrous apex cholesterol granuloma. Am J Otolaryngol. 30(6):407-14, 2009
Castillo MP et al: Petrous apex cholesterol granuloma aeration: does it matter? Otolaryngol Head Neck Surg. 138(4):518-22, 2008
Connor SE et al: Imaging of the petrous apex: a pictorial review. Br J Radiol. 81(965):427-35, 2008
Oyama K et al: Petrous apex cholesterol granuloma treated via the endoscopic transsphenoidal approach. Acta Neurochir (Wien). 149(3):299-302; discussion 302, 2007
Jackler RK et al: A new theory to explain the genesis of petrous apex cholesterol granuloma. Otol Neurotol. 24(1): 96-106; discussion 106, 2003
Brackmann DE et al: Surgical management of petrous apex cholesterol granulomas. Otol Neurotol. 23(4): 529-33, 2002
Hunt JP et al: Cholesterol granuloma of the petrous apex. Ear Nose Throat J. 81(4): 217-8, 2002
Bonneville F et al: Unusual lesions of the cerebellopontine angle: a segmental approach. Radiographics. 21(2): 419-38, 2001
Pisaneschi MJ et al: Congenital cholesteatoma and cholesterol granuloma of the temporal bone: role of magnetic resonance imaging. Top Magn Reson Imaging. 11(2): 87-97, 2000
Chaljub G et al: Magnetic resonance imaging of petrous tip lesions. Am J Otolaryngol. 20(5):304-13, 1999
Palacios E et al: Petrous apex lesions: cholesterol granuloma. Ear Nose Throat J. 78(4): 234, 1999
Chang P et al: Imaging destructive lesions of the petrous apex. Laryngoscope. 108(4 Pt 1): 599-604, 1998
Muckle RP et al: Petrous apex lesions. Am J Otol. 19(2): 219-25, 1998
Eisenberg MB et al: Petrous apex cholesterol granulomas: evolution and management. J Neurosurg. 86(5): 822-9, 1997
Isaacson JE et al: Cholesterol granuloma cyst of the petrous apex. Ear Nose Throat J. 75(7): 425-9, 1996
Morrison GA et al: Cholesterol cyst and cholesterol granuloma of the petrous bone. J Laryngol Otol. 106(5): 465-7, 1992
Clifton AG et al: Cholesterol granuloma of the petrous apex. Br J Radiol. 63(753): 724-6, 1990
Greenberg JJ et al: Cholesterol granuloma of the petrous apex: MR and CT evaluation. AJNR Am J Neuroradiol. 9(6):1205-14, 1988
Amedee RG et al: Cholesterol granuloma of the petrous apex. Am J Otol. 8(1): 48-55, 1987
Griffin C et al: MR and CT correlation of cholesterol cysts of the petrous bone. AJNR Am J Neuroradiol. 8(5): 825-9, 1987
Lo WW et al: Cholesterol granuloma of the petrous apex: CT diagnosis. Radiology. 153(3):705-11, 1984
PA-CG: Expansile PA lesion resulting from foreign body giant cell reaction to deposition of cholesterol crystals in apical air cells with fibrosis and vascular proliferation
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
Fieux M et al: Petrous apex cholesterol granuloma revealed by facial palsy. Ann Neurol. 89(2):414-15, 2021
Albakheet N et al: Familial hypercholesterolemia with bilateral cholesterol granuloma: a case series. Int J Surg Case Rep. 62:135-9, 2019
Campion T et al: Imaging of temporal bone inflammations in children: a pictorial review. Neuroradiology. 61(9):959-70, 2019
Stevens SM et al: Long-term symptom-specific outcomes for patients with petrous apex cholesterol granulomas: surgery versus observation. Otol Neurotol. 38(2):253-9, 2017
Sweeney AD et al: The natural history and management of petrous apex cholesterol granulomas. Otol Neurotol. 36(10):1714-9, 2015
Juliano AF et al: Imaging review of the temporal bone: part I. Anatomy and inflammatory and neoplastic processes. Radiology. 269(1):17-33, 2013
Hoa M et al: Petrous apex cholesterol granuloma: maintenance of drainage pathway, the histopathology of surgical management and histopathologic evidence for the exposed marrow theory. Otol Neurotol. 33(6):1059-65, 2012
Caversaccio M et al: Cholesterol granuloma of the petrous apex: benefit of computer-aided surgery. Eur Arch Otorhinolaryngol. 266(1):47-50, 2009
Sanna M et al: Otoneurological management of petrous apex cholesterol granuloma. Am J Otolaryngol. 30(6):407-14, 2009
Castillo MP et al: Petrous apex cholesterol granuloma aeration: does it matter? Otolaryngol Head Neck Surg. 138(4):518-22, 2008
Connor SE et al: Imaging of the petrous apex: a pictorial review. Br J Radiol. 81(965):427-35, 2008
Oyama K et al: Petrous apex cholesterol granuloma treated via the endoscopic transsphenoidal approach. Acta Neurochir (Wien). 149(3):299-302; discussion 302, 2007
Jackler RK et al: A new theory to explain the genesis of petrous apex cholesterol granuloma. Otol Neurotol. 24(1): 96-106; discussion 106, 2003
Brackmann DE et al: Surgical management of petrous apex cholesterol granulomas. Otol Neurotol. 23(4): 529-33, 2002
Hunt JP et al: Cholesterol granuloma of the petrous apex. Ear Nose Throat J. 81(4): 217-8, 2002
Bonneville F et al: Unusual lesions of the cerebellopontine angle: a segmental approach. Radiographics. 21(2): 419-38, 2001
Pisaneschi MJ et al: Congenital cholesteatoma and cholesterol granuloma of the temporal bone: role of magnetic resonance imaging. Top Magn Reson Imaging. 11(2): 87-97, 2000
Chaljub G et al: Magnetic resonance imaging of petrous tip lesions. Am J Otolaryngol. 20(5):304-13, 1999
Palacios E et al: Petrous apex lesions: cholesterol granuloma. Ear Nose Throat J. 78(4): 234, 1999
Chang P et al: Imaging destructive lesions of the petrous apex. Laryngoscope. 108(4 Pt 1): 599-604, 1998
Muckle RP et al: Petrous apex lesions. Am J Otol. 19(2): 219-25, 1998
Eisenberg MB et al: Petrous apex cholesterol granulomas: evolution and management. J Neurosurg. 86(5): 822-9, 1997
Isaacson JE et al: Cholesterol granuloma cyst of the petrous apex. Ear Nose Throat J. 75(7): 425-9, 1996
Morrison GA et al: Cholesterol cyst and cholesterol granuloma of the petrous bone. J Laryngol Otol. 106(5): 465-7, 1992
Clifton AG et al: Cholesterol granuloma of the petrous apex. Br J Radiol. 63(753): 724-6, 1990
Greenberg JJ et al: Cholesterol granuloma of the petrous apex: MR and CT evaluation. AJNR Am J Neuroradiol. 9(6):1205-14, 1988
Amedee RG et al: Cholesterol granuloma of the petrous apex. Am J Otol. 8(1): 48-55, 1987
Griffin C et al: MR and CT correlation of cholesterol cysts of the petrous bone. AJNR Am J Neuroradiol. 8(5): 825-9, 1987
Lo WW et al: Cholesterol granuloma of the petrous apex: CT diagnosis. Radiology. 153(3):705-11, 1984
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