Cerebral cholesterol granuloma: case report

Abstract

Cholesterol granulomas of the central nervous system are rare lesions and the petrous apex is the intracranial site most frequently involved. Cases of intracranial cholesterol granuloma have been reported associated with familial hypercolesterolemia and high serum lipid levels. With few cases reported in the literature, the pathogenesis of the event is until unclear.The following report shows a case of a young woman with a temporal mass with cholesterol granuloma diagnosed in the pathologic examination. CASEA black 20 year-old woman, presented at our service due to severe progressive headache and drowsiness. Physical and neurologic examination were normal. Neuroimaging showed a heterogeneous cystic mass in the posterior right temporal lobe, extending to the ventricular trigone ( Fig 1A, B, C). A temporal craniotomy was performed, and the lesion was resected completely. The post-operative period was uneventful. Pathologic examination was consistent with cholesterol granuloma. There was no dislipidemia nor familial hypercholesterolemia hystory. At 3-month followup, the patient resumed a normal life, with no complaints. The post-operative image shows no recurrence (Fig 1D).CErEbrAl CholEStErol grAnulomA Key WoRDS: granuloma, foreign-body, cholesterol, brain diseases. granuloma de colesterol cerebral: relato de casoReSUMo -Granulomas de colesterol intracranianos são lesões raras, sendo observados na região do ápice petroso. A ocorrência de granuloma de colesterol intracerebral é um evento incomum. Relata-se o caso de mulher de 20 anos submetida a craniotomia para ressecção de processo expansivo temporal, com exame anátomo-patológico evidenciando um granuloma de colesterol.PAlAvRAS-ChAve: granuloma de corpo estranho, colesterol, doenças cerebrais.

Intracranial Cholesterol Granuloma in a Cat

“…72(11): 1475-1478, 2010 Cholesterol granulomas (CGs) are known as well circumscribed, non neoplastic lesions, resulting from a chronic inflammatory reaction to continuous deposition of cholesterol crystals [10]. In human beings, a diagnosis of CG has been established in several sites throughout the body, comprising the intracranial localisation [4,13,20].In veterinary medicine, the development of an intracranial cholesterol granuloma has been described as an incidental, asymptomatic finding at necropsy in 20% of older horses and the choroid plexus of fourth and lateral ventricles represented the preferential location of the so-called "cholesteatoma of the choroid plexus" [9]. Sporadic descriptions of identical intracranial lesions have been reported in other animals, such as meerkats (Suricata suricatta sp., family Herpestidae) [2,21,22] A 4 year-old neutered male cat was presented at the "Malpensa" Veterinary Clinic (Samarate, Italy) with a 5-month history of progressive weakness, ataxia and depression.…”

“…72(11): 1475-1478, 2010 Cholesterol granulomas (CGs) are known as well circumscribed, non neoplastic lesions, resulting from a chronic inflammatory reaction to continuous deposition of cholesterol crystals [10]. In human beings, a diagnosis of CG has been established in several sites throughout the body, comprising the intracranial localisation [4,13,20].…”

“…In human beings, a diagnosis of CG has been established in several sites throughout the body, comprising the intracranial localisation [4,13,20].…”

Imaging Diagnosis—mri Characteristics of a Fourth Ventricular Cholesterol Granuloma in a Dog

“…Intracranial cholesterol granuloma has been reported in dogs, cats, horses, meerkats, and sporadically in people . The terms cholesterol granuloma and cholesteatoma are used interchangeably in the reports of occurrence in animals; however, these entities are distinct.…”

“…Intracranial cholesterol granuloma has been reported in dogs, cats, horses, meerkats, and sporadically in people. [1][2][3][4][5][6][7][8][9][10] The terms cholesterol granuloma and cholesteatoma are used interchangeably in the reports of occurrence in animals; however, these entities are distinct. Cholesteatomas, also known as epidermoid cysts, have an epithelial lining and may recur after surgical removal and/or undergo malignant transformation.…”