Cholesterol granuloma of maxillary sinus

Ramani, Pratibha; Murugesan, K.; Chandrasekar, Thiruvengadam; Anuja, N

doi:10.1016/j.ijom.2006.04.002

Cited by 14 publications

(13 citation statements)

References 10 publications

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“…The etiologic mechanism by which CG formation occurs is not well understood, however several studies have suggested that they occur as a result of hemorrhage, impaired drainage, and obstruction of ventilation (1, 3-5). One possible mechanism by which CG may occur is as a result of chronic sinusitis or previous surgery that causes an obstruction in the sinus ostium, which in turn results in the resorption of gas in the obstructed cavity.…”

Section: Discussionmentioning

confidence: 99%

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Association of Cholesterol Granuloma and Aspergillosis in the Sphenoid Sinus

Kang

Kim

2008

Korean J Radiol

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Cholesterol granuloma (CG) is usually associated with chronic middle ear disease, and is not common in the paranasal sinuses. Additionally, it is very rare for cases of CG to be associated with a fungal infection. However, in this paper, we report a case of sphenoid sinus CG that is associated with aspergilloma in a 78-year-old male patient who presented with right hemifacial pain, headache and toothache. CT revealed the presence of an expansile cystic mass lesion in the sphenoid sinus that showed a high signal intensity on both the T1 and T2 weighted images. This mass was later determined to be CG. The suspected etiologic mechanisms of both CG and aspergilloma of the paranasal sinuses are similar, and impaired drainage and obstruction of the ventilation of the paranasal sinuses are considered to be the causative mechanism of both diseases. Overall, the results of this study indicate that the use of MRI findings could be helpful for differentiating CG from other paranasal sinus mass lesions.

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Section: Discussionmentioning

confidence: 99%

“…Erythrocyte cell membranes that are destroyed during bleeding then act as a source of cholesterol, which is formed into cholesterol crystals by anaerobic erythrocytes. These crystals then incite foreign body giant cell infiltration, and repeated hemorrhaging ultimately leads to the formation of granulation tissue (1, 3-5). …”

Section: Discussionmentioning

confidence: 99%

Association of Cholesterol Granuloma and Aspergillosis in the Sphenoid Sinus

Kang

Kim

2008

Korean J Radiol

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“…The patient of the present study, though, was an young adult. The patients usually present unspecific symptoms, such as headache, facial pain, nasal discharge and sinusitis; however, the most suggestive symptom is a clear yellowish rhinorrhea (1,6,8). Nasal obstruction and intraoral swelling, as evidenced in the present case, are not commonly found in association to maxillary sinus CG (6,8).…”

Section: Discussionmentioning

confidence: 99%

“…The most common radiographic findings of maxillary sinus CG include opacification of the maxillary sinus, with cystic arrangement or soft tissue density, usually well-defined by sclerotic cortical bone, although bone expansion and erosion can be observed (1,8). Calcification foci are rare (4,6). Differential diagnosis of CG should include allergic and inflammatory sinusal diseases, mucoceles, pyomucoceles, and sinusal odontogenic and non-odontogenic cysts and tumors (6,9).…”

Section: Discussionmentioning

confidence: 99%

Cholesterol granuloma of the maxillary sinus

et al. 2008

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Cholesterol granuloma (CG) is a foreign body reaction to the deposition of cholesterol crystals, usually found in association to chronic middle ear diseases, being highly uncommon in the paranasal sinuses. This article reports a case of CG in the maxillary sinus of a 22-year-old man, manifesting as a swelling on the right maxilla associated with pain and nasal obstruction. Computed tomography (CT) imaging showed complete opacification of the right maxillary sinus with cortical bone expansion and destruction. Incisional biopsy showed a solid mass filling the sinus and histological examination showed foreign body reaction to cholesterol crystals. The microscopic findings associated to tooth vitality, CT images and absence of a cavity during the surgical procedure were compatible with the diagnosis of CG of the maxillary sinus. Complete surgical excision of the mass under general anesthesia was suggested, but the patient did not return to conclude the treatment. CG must be included in differential diagnosis of diseases that cause opacification on the paranasal sinuses, especially sinusitis, and cystic and tumoral lesions.

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“…28 Intraoperatively, some cases have reported a thin shell of bone encasing the lesion. 14,29 Characteristic MRI findings of CG are high-intensity signal on both T1-and T2-weighted imaging, due to the presence of paramagnetic methemoglobin accumulation peripherally. 30 In the present analysis, high-intensity signal was reported in 75% on T1-weighted imaging and 62.5% on T2-weighted imaging, with only 12.5% of the lesions noting low-and moderate-intensity signal on T2-weighting.…”

Section: Group Patient Datamentioning

confidence: 99%