Cholesterol granuloma of the maxillary sinus in a young patient with associated neurosurgical pathology

Coronal MRI shows the mass of the left maxillary sinus that emerges from the ostio-meatal complex reaching the nasal fossa. Associated with this is the dilation of the subarachnoid spaces in the right frontal region with scalloping of the internal bony trabeculae.

Cholesterol granuloma characterized by numerous dense masses of cholesterol crystals surrounded by multinucleated giant cells. Also present, extravasated erythrocytes, foamy histiocytes and lymphomononuclear inflammatory infiltration in the context of edematous tissue (hematoxylin–eosin stain, ×40).

CT with contrast shows a vast layer of the chronic right frontal–parietal subdural hematoma with hematic hyperdensity and right-left shift of the median structures.

CT scan 20 days post-operatively: complete reabsorption of the hematoma and the disappearance of the arachnoid cyst whose previous presence is proven by the minus on the internal bony trabeculae.