Cholesteatoma of the clivus case report

Objective: Cholesteatomas (CNS epidermoids) can be found intradurally or extradurally in the central nervous system. Extradural intraosseous lesions are most commonly found in the petrous bone. Design: Case report Clinical Presentation: The authors describe a unique case of a clival cholesteatoma occurring in a 64-year-old woman who presented with headaches. No other neurological complaints or physical examination findings were noted. Magnetic resonance imaging showed an expansile lesion centered in the middle portion of clivus with erosion of a large portion of the clivus. Results: This lesion was explored via a transnasal transsphenoidal approach and granular debris was evacuated. The cystic lining was stripped from the surrounding bone and the bone opening was widely fenestrated. Pathological examination showed keratinous debris with macrophages and an outer lining of benign epithelial tissue consistent with a cholesteatoma (epidermoid cyst). Conclusions: The authors review the radiographic, surgical, and pathological findings of this unique case.