The giant cholesterol cyst of the petrous apex: a distinct clinical entity

The giant cholesterol cyst (GCC) of the petrous apex may now be considered a distinct clinical entity and should be considered in the differential diagnosis of lesions of the midcranial skull base. This benign cystic lesion of the petrous apex gradually enlarges and may produce progressive bone erosion and serial neurologic deficits of the cranial nerves within the temporal bone and jugular foramen. We report here five instances of this lesion (3 patients with unilateral and 1 patient with bilateral petrous apex lesions) and describe the natural history, diagnostic evaluation, pathology, and surgical management.