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Related Experiment Video

Updated: Jun 12, 2025

Surgical Treatment of an Endolymphatic Sac Tumor
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Intralabyrinthine Cholesterol Granuloma.

Dae-Yang Kim1, Eun-Ju Jeon1, Hyun Jin Lee1

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Ear, Nose, & Throat Journal
|September 23, 2024
PubMed
Summary

Cholesterol granulomas, rare inner ear tumors, can mimic endolymphatic sac tumors on imaging. This case highlights the importance of histopathology for accurate diagnosis and treatment.

Keywords:
cholesterol granulomaendolymphatic sac tumorgranulomaintralabyrinthine cholesterol granuloma

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Area of Science:

  • Otorhinolaryngology
  • Pathology
  • Radiology

Background:

  • Cholesterol granulomas are characterized by cholesterol crystals, giant cells, fibrosis, and inflammation.
  • These lesions commonly affect the middle ear, petrous apex, and orbit, with rare labyrinthine occurrences.
  • Distinguishing cholesterol granulomas from endolymphatic sac tumors preoperatively is challenging due to similar imaging features.

Purpose of the Study:

  • To report a rare case of cholesterol granuloma confined to the labyrinth.
  • To emphasize the diagnostic challenges and the importance of integrating radiological and histopathological findings.

Main Methods:

  • A case study of a 60-year-old woman.
  • Preoperative magnetic resonance imaging (MRI) for diagnosis.
  • Transmastoid surgical procedure.
  • Postoperative histopathological analysis for confirmation.

Main Results:

  • Preoperative MRI suggested an endolymphatic sac tumor.
  • Postoperative histopathology confirmed the lesion as a cholesterol granuloma.
  • The granuloma was uniquely located within the labyrinth.

Conclusions:

  • Cholesterol granulomas can occur rarely within the labyrinth.
  • Accurate diagnosis requires a combination of advanced imaging and definitive histopathological examination.
  • Correct diagnosis is crucial for selecting the appropriate therapeutic strategy.