Supratentorial and cervical extensions of a giant middle ear cholesteatoma

Introduction: Cholesteatomas are slowly progressive and well demarcated lesions but if not treated, they can spread to the inner ear and brain and lead to serious neurological complications.Case report: A 59-year old male was referred to our practice. His initial imaging showed that a huge intracranial mass has spread to the neck. Beyond surgical exploration, a sizable temporal bone lesion with extensive keratinisation was observed which later on histopathological exam turned out to be a cholesteatoma.Conclusions: Cholesteatomas may be aggressive lesions by rapidly growing and gross destructive features. In such cases, more attempts should be given to ruling out any malignant neoplastic tissues.