A primary large cholesterol cyst of the mastoid presenting with dysgeusia.

The occurrence of postoperative secondary cholesterol cysts in the mastoid has been previously reported, however the occurrence of a primary large cholesterol cyst in the mastoid with bony destruction of the facial nerve has rarely been reported. The case report of a 17-year-old female patient with a primary large cholesterol cyst with dysgeusia is presented. Computed tomography and magnetic resonance imaging findings for the lesion distinguish a cholesterol granuloma, cholesteatoma and vascular tumor. The patient underwent a canal wall down mastoidectomy with mastoid obliteration. A dehiscent portion of the mastoid segment of the facial nerve was visible within the cavity; the gross finding of the facial nerve was edematous in appearance. Five years later, there has been no recurrence of disease.