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Updated: May 25, 2025
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Published on: February 29, 2020
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.
Objective:
To report a patient who was misdiagnosed and operated on for cerebrospinal fluid (CSF) otorrhea and to demonstrate that cholesterol granulomas mimic CSF leakage by secreting beta-trace protein (BTP).
Patients:
Eleven consecutive patients undergoing ear surgery in whom cholesterol granulomas were discovered intraoperatively.
Intervention:
Biochemical and histologic analysis of liquid and solid fractions of cholesterol granulomas.
Main Outcome Measures:
BTP and beta-2-transferrin concentrations and BTP mRNA levels in surgical specimens.
Results:
Cholesterol granulomas produce BTP and express high levels of BTP mRNA, but do not produce beta-2-transferrin.
Conclusions:
Beta-2 transferrin analysis is preferable to BTP analysis for the detection of CSF otorrhea because BTP may be false positive in the presence of cholesterol granulomas.
