Residual cholesteatoma of the mastoid cavity presenting with radiologic signal of a cholesterol granuloma: A case report
Bibliographic record
Abstract
Introduction: Cholesteatoma and cholesterol granuloma can both occur in the temporal bone. Their distinct magnetic resonance imaging (MRI) signals are generally used to help differentiate one from the other to plan appropriate treatment, which differs based on the pathology.Case presentation: We present a patient with recent-onset facial paralysis whose mastoid cavity was filled with tissue radiologically resembling cholesterol granuloma but that turned out to be cholesteatoma upon surgical exploration. Complete disease extirpation was thus completed rather than simple marsupialization, the latter of which would have been sufficient in the case of cholesterol granuloma.Discussion: Cholesteatoma, although usually hypointense on T1-weighted imaging (T1WI) MRI, hyperintense on T2-weighted imaging (T2WI) MRI and showing diffusion restriction on diffusion-weighted imaging can occasionally present with an atypical MRI signal, for example, one suggestive of cholesterol granuloma.Conclusions: The clinician should keep in mind the possible diagnosis of cholesteatoma despite an atypical MRI signal in the temporal bone.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.005 | 0.003 |
| Science and technology studies | 0.004 | 0.003 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.009 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".