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Cholesterol Granuloma Mimicking CSF Otorrhea by beta-Trace-Protein Production
Andreas Radeloff, Katrin Radeloff1, Rolf-Peter Henke2
1Division of Otolaryngology, Head and Neck Surgery, University of Oldenburg, Oldenburg, Germany.
Summary
Cholesterol granulomas can mimic cerebrospinal fluid (CSF) otorrhea by producing beta-trace protein (BTP). Beta-2 transferrin testing is more reliable for diagnosing CSF leaks due to potential BTP false positives.
Area of Science:
- Otolaryngology
- Biochemistry
- Pathology
Background:
- Cerebrospinal fluid (CSF) otorrhea diagnosis can be challenging.
- Cholesterol granulomas are benign intra-temporal bone lesions.
- Misdiagnosis can lead to unnecessary surgery.
Purpose of the Study:
- To report a case of misdiagnosed CSF otorrhea.
- To investigate cholesterol granulomas as a source of beta-trace protein (BTP).
- To compare BTP and beta-2-transferrin in diagnosing CSF otorrhea.
Main Methods:
- Analysis of eleven patients with intraoperative cholesterol granulomas.
- Biochemical and histological examination of granuloma tissue.
- Measurement of BTP and beta-2-transferrin concentrations and BTP mRNA levels.
Main Results:
- Cholesterol granulomas were found to produce BTP.
- High levels of BTP mRNA were detected in granuloma specimens.
- Beta-2 transferrin was not produced by the cholesterol granulomas.
Conclusions:
- Beta-trace protein (BTP) can be falsely elevated in the presence of cholesterol granulomas.
- Beta-2 transferrin analysis is a more reliable marker for diagnosing CSF otorrhea.
- Avoidance of unnecessary surgery through accurate CSF leak diagnosis is crucial.
