04 May 2026
: Case report 
Extensive Temporal Bone Necrosis in Petrous Bone Cholesteatoma Complicated by Actinomycosis: A Case Report
Challenging differential diagnosis, Unusual or unexpected effect of treatment, Educational Purpose (only if useful for a systematic review or synthesis), Rare coexistence of disease or pathology
Saverio Nicoletti ABEF 1*, Giannicola Iannella AF 1, Giuseppe Magliulo BD 1, Daniela Messineo
B 2, Alessandro Corsi B 3, Annalisa Pace CE 1
DOI: 10.12659/AJCR.950701
Am J Case Rep 2026; 27:e950701
Figure 1 The CT images were acquired using a 16-slice Philips Incisive CT scanner with parameters set at 217 mA and 120 kV. The white arrows indicate: (A) Axial plane, extensive erosion of the right mastoid; (B) coronal plane, disruption of the right tegmen tympani; (C) parasagittal plane, necrotic osseous sequestrum of the right temporal bone. (D–F) MRI images were acquired using a 3 Tesla GE Discovery MR750W RT scanner. (D) Fat-suppressed T2-weighted qTSE (TE: 78, TR: 8150 ms) magnetic resonance image demonstrates pathological tissue in the right temporal bone. Initial involvement of the eustachian tube is noted (white arrow). (E) Diffusion-weighted MRI image (TE: 66, TR: 2880 ms; b-values 50/800) reveals an area of irregular diffusion restriction and heterogeneous signal consistent with an osseous sequestrum in the right temporal bone (white arrow). (F) Coronal T1-weighted magnetic resonance image (TE: 9.4, TR: 598 ms) shows multiple reactive lateral cervical lymph nodes along the right sternocleidomastoid muscle (white arrows).