Orbital cholesterol granuloma: a retrospective case series

Background To review the clinical features, radiographic features, therapy, pathological features and prognosis of orbital cholesterol granuloma(CG). Methods Twelve patients with orbital CG who were referred to Tianjin Eye Hospital between January 2002 and December 2020 were include in this retrospective case series study. Data collected included patient ophthalmic manifestations, imaging finding, treatment strategies, pathological features and prognosis were retrospectively reviewed. Results The patients comprised 10 males and 2 females. The mean age was 34.5±8.9 years(range 16 to 45 years). Four patients had a history of orbital trauma. The clinical manifestations at first visit were proptosis ( 7/12, 58.3%), periorbital or eyelids swelling (6/12,50%), limitation of eye displacement (4/12,33.3%), ptosis(2/12,16.7%), decreased visual acuity (1/12,8.3%).CT showed a non-enhancing,well-circumscribed lesion in the orbit with extensive erosion of the adjacent frontal bone and temporal bone.MRI showed a non-enhancing mass with intermediate to high signal intensity on T1- and T2-weighted imaging. Ten patients underwent lateral orbitotomy, and two patient underwent supraorbital orbitotomy,.All patients had aggressive bone erosion. Histopathologic evaluation of the cyst contents and wall revealed cholesterol clefts,multinucleated giant cells,histiocytes, foamy macrophages,and altered blood pigments. The median recurrence time of 79.6±49.8 months (range 19 month to 193 months). Three patients were lost to follow-up. No postoperative diminution of vision was noted,and no recurrence was observed. Conclusions Cholesterol granulomas can present as superiotemporal or temporal orbital lesions. The diagnosis can be established based on CT and MRI. Most of patients can have no history of orbital trauma.

First Case Report of Cholesterol Granuloma of Femur

Introduction: Cholesterol granuloma (CG) is a special type of granulation tissue reaction. It is a very rare benign lesion with swelling growth, in which there are a large number of cholesterol crystals and foreign body giant cells. A small amount of literature reports that it occurred in the middle ear or mastoid area. There has been no report of CG of the femur.Methods: A 74-year-old woman suffered from pain and discomfort in the upper right knee for 10 years, which aggravated for 10 days. He was diagnosed with CG of the right femur in our hospital, and was treated with surgery. Results: During the operation, a large amount of yellow-brown oily crystal structure was found, and the pathology after the operation was confirmed as CG. The postoperative follow-up was 3 months, and the treatment effect was satisfactory.Conclusion: CG of the femur is an extremely rare benign lesion, and there is no relevant report. Surgical treatment can remove the diseased tissue and provide effective treatment results.

Nasopharyngeal Approach to a Cholesterol Granuloma of the Petrous Apex

Cholesterol granulomas are rare cystic inflammatory lesions characterized by the formation of cholesterol crystals. They are the most prevalent lesions of the petrous apex and when symptomatic, hearing loss, vertigo, tinnitus, headache, and facial pathology can be present. Surgical management is recommended in symptomatic patients. There are different surgical approaches to cholesterol granulomas. The aim of this article is to present and describe an endoscopic endonasal nasopharyngeal approach to a cholesterol granuloma and explain the advantages and disadvantages.