Science and Education Publishing American Journal of Medical Case Reports 2374-216X 5 2 2017 2 27 Cholesterol Granuloma of Sphenoid Sinus: Report of a Rare Case 35 37 EN Samasuk Thammachantha Department of Pathology, Prasat Neurological Institute, 312 Rajvithi road, Thung phayathai, Rajthewi, Bangkok, Thailand Pichest Metarugcheep Yodkhwan Wattanasen AJMCR2017523 10.12691/ajmcr-5-2-3 2016 10 21 2017 1 14 2017 2 25 Cholesterol granuloma is chronic inflammatory lesion of head and neck region, caused by bleeding of mucosal vessels of paranasal sinus. Histologically, the lesion shows aggregate of cholesterol crystals surrounded by foreign-body giant cell reaction. The symptoms vary depending on location of an expansile mass and Magnetic resonance imaging (MRI) are helpful in distinguish this disease from mucocoele. We present a case of cholesterol granuloma in the right sphenoid sinus of a 52-year-old man, with the oculomotor nerve dysfunction but sparing pupillary reflex.