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Liu Y, Huang Y, Zhu D, Li J, Zhao T, He Y, Xia R, Zhong L. Clinical retrospective analysis with a predictive model for diffused-tenosynovial giant cell tumors of the temporomandibular joint. BMC Cancer 2023; 23:1062. [PMID: 37923984 PMCID: PMC10625237 DOI: 10.1186/s12885-023-11587-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 10/29/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND This study aimed to find out the characteristics in relation to tumor recurrence in diffused-tenosynovial giant cell tumor of temporomandibular joint and to develop and validate the prognostic model for personalized prediction. METHODS From April 2009 to January 2021, patients with diffused-tenosynovial giant cell tumor of temporomandibular joint at a single center were included in this study. The clinical features and local recurrence-free survival were assessed through the expression of the Ki-67 index and colony-stimulating factor 1 receptor expression. Both univariate and multivariate analyses were performed on the prognostic factors for local recurrence-free survival. An independent predictor nomogram and pertinent tumor characteristics were included. RESULTS The retrospective study enrolling seventy eligible patients at the Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. During the follow-up time, eleven patients suffered tumor recurrence. Age was an independent risk factor for local recurrence-free survival (P = 0.032). The Ki-67 index varied significantly in different sites (P = 0.034) and tumor volume (P = 0.017). Multivariate logistic regression was used to develop the prediction model using both statistical significance and prognostic indicators. The C-index of the nomogram based on age, site, Ki-67, and colony-stimulating factor 1 receptor was 0.833. These variates provided good predicted accuracy for a nomogram on local recurrence-free survival. Diffused-tenosynovial giant cell tumor from the temporomandibular joint is extremely uncommon, and certain clinical traits are linked to the tumor proliferation index. CONCLUSIONS We identified the risk indicators and developed a nomogram in this study to forecast the likelihood of local recurrence-free survival in patients with diffused-tenosynovial giant cell tumor from temporomandibular joint.
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Affiliation(s)
- Ying Liu
- Department of Oral & Maxillofacial Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Yingying Huang
- Department of Oral & Maxillofacial Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Stomatology Oral maxillofacial Head and Neck Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Dongwang Zhu
- Department of Oral & Maxillofacial Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Stomatology Oral maxillofacial Head and Neck Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Jiang Li
- Department of Oral Pathology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tongchao Zhao
- Department of Oral & Maxillofacial Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Stomatology Oral maxillofacial Head and Neck Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Yining He
- Biostatistics Office of Clinical Research Unit, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ronghui Xia
- Department of Oral Pathology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Laiping Zhong
- Department of Oral & Maxillofacial Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Department of Stomatology Oral maxillofacial Head and Neck Surgery, Huashan Hospital, Fudan University, Shanghai, China.
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Mei H, Tian C, Lin H, Lu X, Ni Y. Surgical Techniques and Functional Reconstruction for Complex Tenosynovial Giant Cell Tumor of Temporal Bone and Middle Skull Base. EAR, NOSE & THROAT JOURNAL 2023:1455613231186894. [PMID: 37458098 DOI: 10.1177/01455613231186894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023] Open
Abstract
Objectives: Temporal tenosynovial giant cell tumors (TGCTs) are often large and have invaded the middle skull base. It is difficult to protect the important neurovascular structures around the tumor and perform functional reconstruction on the basis of complete tumor resection. This study aimed at analyzing the surgical techniques and functional reconstruction during the operation of complex TGCT of temporal bone and middle skull base. Methods: Five patients with pathologically confirmed TGCT of different complex types in the temporal bone and middle skull base were treated in our hospital from December 2020 to February 2023. We collected and retrospectively analyzed their medical records, including medical imaging, surgical procedures, and follow-up data. Results: The tumors invaded beyond the temporal bone and destroyed the middle skull base in all cases, involving the intracranial space and other important neurovascular structures. The internal carotid artery, infratemporal fossa, pterygopalatine fossa, and parapharyngeal space were also involved in 1 case. All the patients' tumors were completely removed, and the operations were performed mainly via modified infratemporal fossa approach, or combined with expanded middle cranial fossa approach. All cases with temporal and skull base destruction were repaired using the temporalis muscle flap with no occurrence of intracranial complications. The dura mater, condyle of temporomandibular joint, facial nerve, and internal carotid artery were fully preserved. Normal maxillofacial morphology was also preserved. The air conductive hearing of 2 patients was preserved. Conclusions: We found and summarized some surgical techniques that can help safeguard the important structures around massive TGCTs of temporal bone and middle skull base, and reconstruct the defects after tumor resection. The techniques are effective and feasible.
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Affiliation(s)
- Honglin Mei
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Cirong Tian
- Department of Otolaryngology, Shenzhen Second People's Hospital, Shenzhen, China
| | - Hailiang Lin
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Xiaoling Lu
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
| | - Yusu Ni
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, China
- Otology and Skull Base Surgery, Eye & ENT Hospital, Fudan University, Shanghai, China
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3
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Huo L, Han Z, Jiao Z, Wei X, Xu Q, Ahmed A, Zheng J, Chen M, Yang C. Introduction of temporomandibular joint and skull base combined reconstruction by autogenous bone graft. Clin Oral Investig 2023:10.1007/s00784-023-05065-4. [PMID: 37221432 DOI: 10.1007/s00784-023-05065-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/07/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVE This study introduces the application of autogenous bone graft for the reconstruction of temporomandibular joint (TMJ) and skull base combined defects. MATERIALS AND METHODS Patients treated with autogenous bone grafts for reconstruction of the TMJ and skull base were reviewed. All patients underwent virtual surgical design to confirm the osteotomies of the combined lesion and the selections of autogenous bone graft, fabrication of surgical templates to transfer the plan to actual operation, and reconstruction of autogenous bone graft for the TMJ and/or skull base. Surgical outcomes were assessed by clinical examinations and radiological data. RESULTS Twenty-two patients were involved in this study. Ten patients underwent reconstruction of the skull base by a free iliac or temporal bone graft and preservation of the TMJ. Twelve patients underwent skull base reconstruction by the same methods and total reconstruction of the TMJ by half sternoclavicular joint flap or costochondral bone graft. No severe complications occurred after surgery. The occlusion relationship was stable and similar to that of the preoperative state. The pain and maximal interincisal opening were significantly improved by the 101.2-month follow-up. CONCLUSION Autogenous bone graft is a good alternative for repairing the TMJ and the skull base structure and function. CLINICAL RELEVANCE The study introduced the application of autogenous bone graft for the reconstruction of temporomandibular joint and skull base combined defect, which is a good way to repair the defect and restore the function.
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Affiliation(s)
- Liang Huo
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, No. 639 Zhi Zao Ju Rd, Shanghai, 200011, China
| | - Zixiang Han
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, No. 639 Zhi Zao Ju Rd, Shanghai, 200011, China
| | - Zixian Jiao
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, No. 639 Zhi Zao Ju Rd, Shanghai, 200011, China
| | - Xiang Wei
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, No. 639 Zhi Zao Ju Rd, Shanghai, 200011, China
| | - Qingyu Xu
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, No. 639 Zhi Zao Ju Rd, Shanghai, 200011, China
| | - Abdelrehem Ahmed
- Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Jisi Zheng
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, No. 639 Zhi Zao Ju Rd, Shanghai, 200011, China.
| | - Minjie Chen
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, No. 639 Zhi Zao Ju Rd, Shanghai, 200011, China.
| | - Chi Yang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, No. 639 Zhi Zao Ju Rd, Shanghai, 200011, China.
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Effects of CT/MRI Image Fusion on Cerebrovascular Protection, Postoperative Complications, and Limb Functional Recovery in Patients with Anterior and Middle Skull Base Tumors: Based on a Retrospective Cohort Study. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:7855576. [PMID: 36159172 PMCID: PMC9489402 DOI: 10.1155/2022/7855576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/18/2022] [Accepted: 08/18/2022] [Indexed: 11/17/2022]
Abstract
Objective. To explore the effect of CT/MRI image fusion on cerebrovascular protection, postoperative complications and limb function recovery in patients with anterior and middle skull base tumors. Methods. During January 2019 to December 2021, a retrospective study was conducted on 50 patients who underwent anterior and middle skull base tumor resection in the same surgeon group in our hospital. According to the different surgical approaches, the patients were assigned to the fusion group (n = 29) and the routine group (n = 21). The routine group was operated with traditional operation, and the fusion group was operated with CT/MRI image fusion technique. The operation time, wound volume, resection rate and Karnofsky performance status (KPS), blood transfusion (vascular protection), tumor resection rate, and postoperative complications were compared. Results. The time of operation in the fusion group was shorter compared to the routine group, and the volume of the wound cavity in the fusion group was smaller compared to the routine group, and the difference was statistically significant (
). Following treatment, the KPS score of the fusion group was remarkably higher compared to the routine group, and the difference was statistically significant (
). The intraoperative blood transfusion rate in the fusion group was 17.24%, and the intraoperative blood transfusion rate in the routine group was 47.62%, and the difference was statistically significant (
). The resection rate in the fusion group (89.66%) was remarkably higher compared to the routine group (61.90%,
). The incidence of postoperative complications in the fusion group (6.90%) was remarkably lower compared to the control group (33.33%,
). Conclusion. The application of CT/MRI image-fusion technology can effectively enhance the clinical symptoms of patients with tumors in the anterior and middle region of the skull base, which can promote the prognosis, shorten the operation time, reduce unnecessary cerebral neurovascular injuries, and retain more brain functions.
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Hamel-Lemaire S, Fortin M, Avon SL. Pigmented villonodular synovitis of the temporomandibular joint: case report and literature review. J Oral Maxillofac Surg 2022; 80:1691-1704. [DOI: 10.1016/j.joms.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 11/26/2022]
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Hu S, Cheng S, Wu Y, Wang Y, Li X, Zheng J, Li J, Peng L, Yang J. A Large Cavernous Sinus Giant Cell Tumor Invading Clivus and Sphenoid Sinus Masquerading as Meningioma: A Case Report and Literature Review. Front Surg 2022; 9:861739. [PMID: 35402500 PMCID: PMC8991686 DOI: 10.3389/fsurg.2022.861739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/11/2022] [Indexed: 12/01/2022] Open
Abstract
Giant cell tumor (GCT) of the bone is a rare benign, locally aggressive tumor that occurs in the epiphysis of long bones, especially the lower femur and the upper tibia. GCT of the bone of cranial origin is very rare, accounting for 1% of all GCT of the bone. We report the diagnosis, treatment, and immunohistochemistry of a rare case of intracranial GCT of the bone. We also review and summarize the imaging features, diagnostic markers, and current major treatment options for GCT of the bone. Our case and literature review emphasizes the importance of considering the full picture when making a diagnosis, rather than relying on imaging alone to make the diagnosis.
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Affiliation(s)
- Shasha Hu
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Shaowen Cheng
- Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China.,Department of Wound Repair, First Affiliated Hospital of Hainan Medical University, Haikou, China.,Key Laboratory of Emergency and Trauma Ministry of Education, Hainan Medical University, Haikou, China
| | - Yu Wu
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Yanyan Wang
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - XinNian Li
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Jiaxuan Zheng
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Jiao Li
- Department of Pathology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Lei Peng
- Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China.,Key Laboratory of Emergency and Trauma Ministry of Education, Hainan Medical University, Haikou, China
| | - Jian Yang
- Trauma Center, The First Affiliated Hospital of Hainan Medical University, Haikou, China.,Department of Wound Repair, First Affiliated Hospital of Hainan Medical University, Haikou, China.,Key Laboratory of Emergency and Trauma Ministry of Education, Hainan Medical University, Haikou, China
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7
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He Q, Zan X, Chen F, You C, Xu J. Pigmented villonodular synovitis of the temporomandibular joint with skull base extension: a retrospective case series. Sci Rep 2022; 12:5763. [PMID: 35388075 PMCID: PMC8987063 DOI: 10.1038/s41598-022-09732-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 03/22/2022] [Indexed: 02/05/2023] Open
Abstract
Most studies on pigmented villonodular synovitis (PVNS) of the temporomandibular joint (TMJ) with skull base extension mostly are case report. Here, we summarize the clinical features, treatments, and outcomes of PVNS of the TMJ with skull base extension in a large case series. We reviewed the clinical information relating to patients diagnosed with PVNS of the TMJ with skull base extension information of patients in our center between 2011 and 2020. We reviewed 10 patients (4 males and 6 females). All cases had presented with a unilateral lesion extending the middle skull base. PVNS of the TMJ with skull base extension occurred on the left side in 6 patients (60%) and on the right side in 4 patients (40%). Of the 10 patients, pain and mass were the most prevalent symptoms. All patients received surgery and no recurrence was seen after 35.90 ± 25.35 months follow-up. Despite destructive biological behavior, surgery can achieve an excellent outcome for patients with PVNS of the TMJ with skull base extension. An en bloc resection may prevent recurrence and provide long-term relief. Radiotherapy may be reserved for subtotal excision and recurrent lesions but require further investigation.
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Affiliation(s)
- Qiang He
- Department of Neurosurgery, West China Hospital, Sichuan University, 37 Guoxue lane, Chengdu, 610041, Sichuan, China
| | - Xin Zan
- Department of Neurosurgery, West China Hospital, Sichuan University, 37 Guoxue lane, Chengdu, 610041, Sichuan, China
| | - Fei Chen
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital, Sichuan University, 37 Guoxue lane, Chengdu, 610041, Sichuan, China
| | - Chao You
- Department of Neurosurgery, West China Hospital, Sichuan University, 37 Guoxue lane, Chengdu, 610041, Sichuan, China
| | - Jianguo Xu
- Department of Neurosurgery, West China Hospital, Sichuan University, 37 Guoxue lane, Chengdu, 610041, Sichuan, China.
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8
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Lin F, Zhang Y, Zhao P, Kong D, Feng Y, Dai C. Grading System and Surgical Strategy for Temporal Bone Diffuse-Type Tenosynovial Giant Cell Tumor. Laryngoscope 2021; 132:1275-1284. [PMID: 34709658 DOI: 10.1002/lary.29913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/05/2021] [Accepted: 10/09/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To develop a novel grading system and appropriate surgical approaches for patients with diffuse type tensosynovial giant cell tumor (D-TGCT) of the temporal bone. STUDY DESIGN Retrospective cohort study. METHODS We retrospectively reviewed 31 patients with temporal bone D-TGCT between June 2012 and July 2021. All patients underwent comprehensive clinical evaluations, including clinical presentations, hearing threshold, imaging studies, surgical approaches, and prognosis. A grading system was developed based on the tumor location and adjacent neurovascular structures involvement according to imaging and intraoperative findings. RESULTS In this study, grade II tumors were the most common (13/31), followed by grades I (7/31), III (7/31), and IV (4/31) tumors. Seven grade I patients received the subtemporal middle cranial fossa approach (SMCF) combined with the canal wall up mastoidectomy and tympanoplasty (CWUT). Nine grade II patients underwent SMCF combined with subtotal petrosectomy (SPTR), and four grade II patients underwent SMCF combined with CWUT. Seven grade III patients received SMCF combined with SPTR and dura mater reconstruction, and four grade IV patients underwent infratemporal fossa approach type B. Gross total resection was achieved in all patients, and the median follow-up time was 30.1 months (range, 4-96 months). Three patients (one grade II, one grade III, and one grade IV) had recurrence during follow-up, and the patient with grade III tumor had two recurrences. CONCLUSIONS Gross total resection is the first-line treatment for patients with D-TGCT of the temporal bone. This novel grading system enables surgeons to select optimal surgical strategy. Long-term follow-up is mandatory postoperatively. LEVEL OF EVIDENCE 4 Laryngoscope, 2021.
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Affiliation(s)
- Feng Lin
- Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.,Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.,Affiliated Nanping First Hospital, Fujian Medical University, Nanping, China
| | - Yibo Zhang
- Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.,Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Peng Zhao
- Longgang Ear, Nose and Throat Hospital, Shenzhen, China
| | - Dedi Kong
- Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.,Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Yisi Feng
- Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.,Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Chunfu Dai
- Department of Otology and Skull Base Surgery, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.,Key Laboratory of Hearing Medicine, Ministry of Health, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
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Suzuki S, Tsuda H, Bandoh N, Goto T, Uemura A, Aoyama T, Nishio A, Makino S, Yamaguchi T, Aimono E, Nishihara H, Harabuchi Y. Diffuse-Type Tenosynovial Giant Cell Tumor Arising in the Temporomandibular Joint Extending to the External Auditory Canal: A Case Report and Literature Review. EAR, NOSE & THROAT JOURNAL 2021; 102:291-296. [PMID: 33752465 DOI: 10.1177/01455613211002954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
A 74-year-old Japanese woman with a 1-year history of right preauricular pain and a 2-month history of bleeding from the right ear was admitted to our department. Tumor was observed in the anterior wall in the right external auditory canal. Bony swelling of the right preauricular area was palpated. Computed tomography revealed an ill-defined, osteogenic tumor around the mandibular condyle with a destructive bony lesion involving the temporal bone. Magnetic resonance imaging revealed a 2.0 × 1.5 × 1.3-cm solid tumor around the mandibular condyle, exhibiting a low-intensity signal on T1-weighted imaging and an isointense central area surrounded by low-signal intensity on T2-weighted imaging. Histological examination of biopsy specimens revealed diffuse-type tenosynovial giant cell tumor (D-TGCT). After the feeding arteries for the tumor were embolized, the patient underwent surgery with combined temporal craniotomy and mandibular condylectomy. The soft and cystic tumor with calcification located in the extradural space was totally resected along with the mandibular condyle. No facial paralysis or recurrence was evident as of 6 months postoperatively. To date, only 23 cases of D-TGCT arising in the temporomandibular joint (TMJ) with ear involvement have been reported since 2011. We report successful resection of a rare case of D-TGCT arising in the TMJ.
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Affiliation(s)
- Shiori Suzuki
- Department of Otolaryngology-Head and Neck Surgery, 38408Hokuto Hospital, Obihiro, Hokkaido, Japan.,Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Japan
| | - Hiroshige Tsuda
- Department of Neurosurgery, 38408Hokuto Hospital, Obihiro, Japan
| | - Nobuyuki Bandoh
- Department of Otolaryngology-Head and Neck Surgery, 38408Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Takashi Goto
- Department of Otolaryngology-Head and Neck Surgery, 38408Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Akihiro Uemura
- Department of Otolaryngology-Head and Neck Surgery, 38408Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Takako Aoyama
- Department of Neurosurgery, 38408Hokuto Hospital, Obihiro, Japan
| | - Akimasa Nishio
- Department of Neurosurgery, 38408Hokuto Hospital, Obihiro, Japan
| | - Shujiroh Makino
- Department of Dental and Oral Surgery, 38408Hokuto Hospital, Obihiro, Japan
| | | | - Eriko Aimono
- Keio Cancer Center, 38084Keio University School of Medicine, Tokyo, Japan
| | - Hiroshi Nishihara
- Keio Cancer Center, 38084Keio University School of Medicine, Tokyo, Japan
| | - Yasuaki Harabuchi
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Japan
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10
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Choi YJ, Lee C, Jeon KJ, Han SS. Computed tomography and magnetic resonance imaging characteristics of giant cell tumors in the temporomandibular joint complex. Imaging Sci Dent 2021; 51:149-154. [PMID: 34235060 PMCID: PMC8219448 DOI: 10.5624/isd.20200300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/01/2020] [Accepted: 12/08/2020] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to investigate the computed tomography and magnetic resonance imaging features of giant cell tumors in the temporomandibular joint region to facilitate accurate diagnoses. Materials and Methods From October 2007 to June 2020, 6 patients (2 men and 4 women) at Yonsei University Dental Hospital had histopathologically proven giant cell tumors in the temporomandibular joint. Their computed tomography and magnetic resonance imaging findings were reviewed retrospectively, and the cases were classified into 3 types based on the tumor center and growth pattern observed on the radiologic findings. Results The age of the 6 patients ranged from 25 to 53 years. Trismus was found in 5 of the 6 cases. One case recurred. The mean size of the tumors, defined based on their greatest diameter, was 32 mm (range, 15–41 mm). The characteristic features of all cases were a heterogeneously-enhancing tumorous mass with a lobulated margin on computed tomographic images and internal multiplicity of signal intensity on T2-weighted magnetic resonance images. According to the site of origin, 3 tumors were bone-centered, 2 were soft tissue-centered, and 1 was peri-articular. Conclusion Computed tomography and magnetic resonance imaging yielded a tripartite classification of giant cell tumors of the temporomandibular joint according to their location on imaging. This study could help clinicians in the differential diagnosis of giant cell tumors and assist in proper treatment planning for tumorous diseases of the temporomandibular joint.
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Affiliation(s)
- Yoon Joo Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Korea
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