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Cholesterol granuloma (CG) occurs primarily in the middle ear and rarely in the paranasal sinus. We report an unusual case of paranasal sinus CG with 18F-FDG uptake. A 76-year-old man presented with right refractory epistaxis. PET/CT showed FDG uptake in the maxillary sinus. CT findings are typically uncharacteristic, whereas MRI scans are characterized by a high signal on both T1-weighted and T2-weighted images. Nasal endoscopy from the ostium revealed a granulomatous lesion with hemorrhage at the base of the maxillary sinus. After pathological examination by endoscopic sinus surgery, the patient was diagnosed with CG. Received for publication June 24, 2020; revision accepted August 24, 2020. Conflicts of interest and sources of funding: This work was supported by JSPS KAKENHI grant (no. 19K09890). None declared to all authors. Correspondence to: Masaki Hayama, MD, PhD, Department of Otorhinolaryngology–Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita City, Osaka 565-0871, Japan. E-mail: mhayama@ent.med.osaka-u.ac.jp. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
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