Cholesterol granuloma

Case contributed by Frank Gaillard
Diagnosis almost certain
mri
Axial T1
C+ fat sat
This study is a stack
Coronal
T1
Coronal T1
C+ fat sat
Coronal
T2
Sagittal
T1
This study is a stack
Axial
T1
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Info

MRI through the base of skull demonstrates a well circumscribed mass at the left petrous apex. It shows striking high T1 signal and demonstrates no convincing enhancement or fat suppression on fat suppressed post contrast images. 

T2 signal is heterogeneous with a thin rim of signal drop out peripherally.

Case Discussion

Appearances are consistent with a cholesterol granuloma also known in this location as a giant cholesterol cyst.

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