PDF: Cholesterol Granuloma of the Maxillary Sinus

Cholesterol granuloma (CG) can be found in several areas of the body, including middle ear (its most common site, usually associated to chronic middle ear diseases), mastoid process, breast, sella turcica, pontocerebelline angle, testis, lungs, brain, kidneys and in the apex of the temporal bone pyramid.

It has been considered a rare entity in the maxillary sinus, with less than 40 reported cases in the English-language literature up to 2007, since its first description in this anatomic site by Graham and Michael in 1978.

The purpose of this paper is to report a case of CG in the maxillary sinus of a young adult, emphasizing the rarity and differential diagnosis of this lesion.

A 22-year-old male entered the Department of Oral and Maxillofacial Surgery of Getúlio Vargas State Hospital, Rio de Janeiro, Brazil, presenting symphisal mandibular fracture caused by a gunshot.

Intraoral examination showed, in addition to the fracture, a tender painful swelling on the right maxilla with fistula and pain, associated to nasal obstruction.

His right maxillary teeth were vital and presented no mobility. Computed tomography (CT) findings showed the mandible fracture and complete opacification of the right maxillary sinus, with expansion and focal destruction of the cortical bone, extending into the right nasal cavity.

This article reports a case of CG in the maxillary sinus of a 22- year-old man, manifesting as a swelling on the right maxilla associated with pain and nasal obstruction.