Xanthomas are associated with a spectrum of medical conditions, most common
ly disorders of lipid storage and lipid metabolism. They occur primarily in
the subcutaneous tissues, especially along the Achilles tendon and the ext
ensor tendons of the hands. Intracranial xanthomas are extremely rare. We p
resent a case of an extensive xanthoma of the temporal bone in a patient wi
th hyperlipidemia.