A Case Report of a Giant Cholesteatoma

Cholesteatoma is a well demarcated, non-neoplastic, temporal bone cystic lesion with extensive keratinisation. Keratoma and epidermoid cyst are other possibly more accurate names suggested to describe the same. It can be classified as congenital or acquired. Its management is often complicated by its tendency to recidivism/recurrence. Long standing cholesteatomas can be a precursor for squamous cell carcinoma. We hereby present a case of giant cholesteatoma in a 45-year-old female with radiological involvement of the left temporal region, periauricular region and infratemporal fossa with lytic destruction of left middle ear ossicles, mastoid and squamous part of temporal bone with intracranial extension. The enormity of the present lesion along with its bony erosions raised the strong clinical suspicion of malignancy. The underlying case report highlights the relevance of exhaustive sectioning and immunohistochemistry to reach the diagnosis.