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Huang CG, Li MZ, Wang SH, Tang XQ, Zhang HL, Haybaeck J, Yang ZH. Giant cell tumor of tendon sheath: A report of 216 cases. J Cutan Pathol 2023; 50:338-342. [PMID: 36287206 DOI: 10.1111/cup.14344] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND In this article on giant cell tumor of tendon sheath (GCTTS), we intend to summarize and analyze the clinical and pathological features of GCTTS hoping to improve clinical management and patient treatment. METHODS The study retrospectively reviewed 216 patients of GCTTS, registered at the Affiliated Hospital of Southwest Medical University from January 2010 to December 2020. These cases were diagnosed by surgical excision. The clinicopathological features and the prognosis were reviewed in the light of the current literature. RESULTS Of these 216 GCTTS patients, 72 were males (33.3%) and 144 females (66.7%), with a ratio male-to-female of 1:2. The patients' age ranged from 5 to 82, the average being 41.5 years at diagnosis. A total of 96 cases (44.4%) occurred in the hand region, followed by 35 cases (16.2%) in the knee, 32 cases (14.8%) in the foot, 25 cases (11.6%) in the ankle, 12 cases (5.6%) in the wrist, 12 cases (5.6%) in the leg, 2 cases (0.9%) in the head, 1 case (0.5%) in the forearm, and 1 case (0.5%) inside and outside the spinal channel. Histopathology mainly revealed large synovial-like monocytes, small monocytes, and osteoclast-like giant cells. CONCLUSION Our results confirm that GCTTS predominantly occurs in the hands of young women. Complete surgical resection with long-term follow-up is the preferred management.
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Affiliation(s)
- Cong-Gai Huang
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Meng-Ze Li
- Department of Orthopaedics, Luzhou Hospital of Traditional Chinese Medicine, Luzhou, China
| | - Shao-Hua Wang
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Xiao-Qin Tang
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Hui-Ling Zhang
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Johannes Haybaeck
- Institute of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Innsbruck, Austria
- Diagnostic and Research Center for Molecular BioMedicine, Institute of Pathology, Medical University Graz, Graz, Austria
| | - Zhi-Hui Yang
- Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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Kanbour A, Hurrell M, Ricciardo P. Management of tenosynovial giant cell tumour of the temporomandibular joint: a systematic review. ANZ J Surg 2022; 93:869-875. [PMID: 37052058 DOI: 10.1111/ans.18186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 12/23/2022]
Abstract
Diffuse type tenosynovial giant cell tumour of the temporomandibular joint (D-TGCT-TMJ) is a rare proliferative disorder. The aim of this study was to perform a systematic review of the literature to summarize D-TGCT-TMJ management regimes and recurrence rates with at least 12 months of follow-up. Our secondary aim was to propose a minimum period of post-operative follow-up. A medline search for any D-TGCT-TMJ case detailing treatment, follow-up of at least 12 months, and presence of recurrence was undertaken. The following variables were extracted from the studies: patient's age and sex, presence of middle cranial fossa invasion, treatment undertaken, total length of follow-up, and presence of recurrence. All studies were assessed for bias as per the Joanna Briggs Institute systematic reviews appraisal tool. There were 63 cases reviewed and were predominantly managed with total resection (60.3%). Other modalities included: arthroplasty, subtotal resection with or without postoperative radiotherapy, medical therapy and surveillance. The recurrence rate was 9.52% and the longest follow-up period where recurrence was observed was at 60 months. Total resection and arthroplasty are common D-TGCT-TMJ management regimes. Patients with D-TGCT-TMJ should be followed up annually for at least 5 years postoperatively to assess for recurrence.
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Affiliation(s)
- Abdullah Kanbour
- Department of Oral and Maxillofacial Surgery Royal Perth Hospital Perth Western Australia Australia
| | - Michael Hurrell
- Department of Oral and Maxillofacial Surgery Royal Perth Hospital Perth Western Australia Australia
| | - Peter Ricciardo
- Department of Oral and Maxillofacial Surgery Royal Perth Hospital Perth Western Australia Australia
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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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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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Liu X, Wan S, Abdelrehem A, Chen M, Yang C. Benign temporomandibular joint tumours with extension to infratemporal fossa and skull base: condyle preserving approach. Int J Oral Maxillofac Surg 2020; 49:867-873. [PMID: 32044186 DOI: 10.1016/j.ijom.2019.12.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 11/11/2019] [Accepted: 12/24/2019] [Indexed: 11/28/2022]
Abstract
This article introduces a modified surgical approach combining condylotomy with posterior disc attachment release for the resection of large non-malignant masses located in the infratemporal fossa and involving the skull base. This retrospective study included 14 patients treated at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University between January 2010 and December 2016. Clinical evaluations (visual analogue scale (VAS) for pain, maximum inter-incisal opening (MIO), and complications) and radiological findings (magnetic resonance imaging (MRI) and computed tomography (CT)) were collected pre- and postoperatively. All patients had satisfactory surgical exposure and complete resection of the neoplasms. During an average follow-up of 54.8 months, no clinical or radiographic signs of recurrence were reported. MIO increased from 28mm preoperatively to 35.4mm postoperatively (P<0.001). The pain VAS score changed from 5.4 preoperatively to 0.7 postoperatively (P<0.001). Neural function was normal for all patients. Postoperative MRI and CT scans showed a satisfactory disc position and condyle morphology, with no resorption. Three-dimensional reconstruction of the postoperative CT scan also demonstrated healing of the skull base defects. The modified surgical approach combining condylotomy with posterior disc attachment release is suitable for the removal of large non-malignant masses involving the infratemporal fossa and skull base.
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Affiliation(s)
- X Liu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - S Wan
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - A Abdelrehem
- Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - M Chen
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - C Yang
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China.
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Wang DD, Luo HY, Guo CB, Meng JH. Clinical and immunohistochemical analysis of diffuse tenosynovial giant cell tumour of the temporomandibular joint. Int J Oral Maxillofac Surg 2020; 49:882-888. [PMID: 32014315 DOI: 10.1016/j.ijom.2019.10.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 09/08/2019] [Accepted: 10/21/2019] [Indexed: 12/12/2022]
Abstract
The objective of this study was to summarize diagnostic points and treatment strategies for diffuse tenosynovial giant cell tumours (D-TSGCTs) of the temporomandibular joint (TMJ), and to evaluate the expression of proteins related to bone destruction and recurrence. The clinical and histopathological characteristics of 24 cases were analysed retrospectively. TRAP staining and immunohistochemical staining for MMP-9, MMP-13, and Ki-67 were performed. The median age of the patients was 45.5 years; the female to male ratio was 1.7:1. In 11 cases (45.8%), skull base destruction seen on computed tomography was confirmed by surgery. Computer-assisted navigation was performed in six cases. Four patients received adjuvant radiotherapy after first surgery. Five patients had recurrent lesions. Multinucleated giant cells were positive for TRAP, MMP-9, and MMP-13. The average Ki-67 index of the recurrent cases was significantly higher than that of the non-recurrent ones (P<0.05). This study demonstrates the aggressive and recurrent nature of D-TSGCT occurring in the TMJ. Computer-assisted navigation is helpful to protect vital structures and determine margins. Adjuvant postoperative radiotherapy is recommended for local control of residual or recurrent tumour. In conclusion, MMP-9 and MMP-13 may play a role in bone destruction of D-TSGCT, and the Ki-67 index has predictive significance for recurrence.
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Affiliation(s)
- D-D Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China
| | - H-Y Luo
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, China
| | - C-B Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
| | - J-H Meng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
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Zhao Q, Lu H. Giant cell tumor of tendon sheath in the wrist that damaged the extensor indicis proprius tendon: a case report and literature review. BMC Cancer 2019; 19:1057. [PMID: 31694605 PMCID: PMC6836650 DOI: 10.1186/s12885-019-6293-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 10/25/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Giant cell tumor of the tendon sheath (GCTTS) is a benign soft tissue (synovial membrane) tumor that rarely involves the hands or wrists. And Tendon impairment caused by GCTTS is extremely rare. CASE PRESENTATION Here, we reported a case of a 60-year-old female with a 10-year history of gradually increasing mass in her left dorsal wrist. The EIP tendon was partially impaired by the mass.The patient was treated with surgical excision of the mass and reconstruction of the EIP tendon. The histopathological examination suggested the presence of GCTTS. After surgery, the patient had adequate functional recovery and no tumor recurrence after 2 years' follow-up. CONCLUSION GCTTS in hands and wrists rarely damages the tendon. Early diagnosis and proactive interventions may likely contribute to good prognostic outcomes.
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Affiliation(s)
- Qingfang Zhao
- Department of Plastic Surgery, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province 310003 People’s Republic of China
| | - Hui Lu
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province 310003 People’s Republic of China
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Brant JA, Kaufman AC, Luu N, Grady SM, O Apos Malley BW, Ruckenstein MJ. Pigmented Villonodular Synovitis Presenting as Unilateral Hearing Loss: Review of the Literature and Case Report. ORL J Otorhinolaryngol Relat Spec 2019; 81:171-182. [PMID: 31242479 DOI: 10.1159/000499473] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 03/08/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS To review the existing literature on pigmented villonodular synovitis (PVNS) of the temporomandibular joint (TMJ) and report a rare case of PVNS of the TMJ presenting with unilateral hearing loss. METHODS Review of the existing literature and a description of personal experience with PVNS of the TMJ presenting with unilateral hearing loss. RESULTS Review of the existing literature revealed 76 reported cases of PVNS of the TMJ. The most common presenting symptom was of a slowly enlarging mass or swelling of the preauricular area, with dysfunctional TMJ also frequently reported. All patients underwent surgical excision with some pursuing radiation as adjuvant therapy. Presented Patient: A 46-year-old man presented with several months of unilateral subjective hearing loss and aural fullness. Imaging revealed a mass centered along the superior TMJ with expansion through the squamous temporal bone and extra-axial intracranial extension into the middle cranial fossa. Imaging characteristics and fine-needle aspiration biopsy were consistent with PVNS. INTERVENTION The patient underwent near-total excision of the mass via frontotemporal craniectomy and lateral temporal bone resection. FOLLOW-UP At the 16-month follow-up there was no evidence of disease recurrence. CONCLUSION PVNS of the TMJ represents a rare entity that can present with a variety of symptoms including unilateral hearing loss.
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Affiliation(s)
- Jason A Brant
- Department of Otorhinolaryngology - Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Adam C Kaufman
- Department of Otorhinolaryngology - Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA,
| | - Neil Luu
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sean M Grady
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Bert W O Apos Malley
- Department of Otorhinolaryngology - Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael J Ruckenstein
- Department of Otorhinolaryngology - Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Yan H, Wang F, Xiang L, Zhu W, Liang C. Diffuse giant cell tumors of the tendon sheath in temporomandibular joint: Two case reports and review of the literature. Medicine (Baltimore) 2018; 97:e11101. [PMID: 29924004 PMCID: PMC6024461 DOI: 10.1097/md.0000000000011101] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
RATIONALE Diffuse giant cell tumors of the tendon sheath (GCT-TS) in the temporomandibular joint (TMJ) are extremely rare. PATIENT CONCERNS We reported the imaging appearance and the pathological findings of 2 male cases with diffuse GCT-TS in the TMJ (52 years for the case 1 and 50 years for the case 2) who complain of the hearing disorders of left ear when presenting to our hospital. DIAGNOSIS Preoperative computerized tomography (CT) scan revealed an irregular mass in the left temporal fossa with the sizes of approximately 5.8 × 3.8 × 4.6 cm for case 1 and 4.2 × 3.2 × 4.3 cm for case 2, respectively. Magnetic resonance imaging (MRI) findings showed a mass of 6.1 × 4.0 × 5.1 cm and 5.3 × 3.6 × 3.3 cm, respectively. Postoperative pathological examination revealed the diffuse multinucleated giant cells accompanied with synovial cells in the diffuse arrangement. Immunohistochemical examination showed CD68 (+), Vim (+), S-100 (-) and 2% of Ki-67 proliferation index. These characteristics are in line with the diagnosis of the diffuse GCT-TS in the TMJ. INTERVENTIONS Both cases underwent the gross total resection followed by radiation therapy. OUTCOMES Two patients experienced no recurrence after follow-up of 1 to 2 year(s). LESSONS Diffuse GCT-TS in the TMJ is very rare. Clinicians should keep in mind the possibility of the GCT-TS when aggressive lesions involve the TMJ and adjacent bone destruction was found. Careful pre- and postoperative examinations and complete resection are the factors that lead to its optimal treatment, significantly reducing its recurrence rate.
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Affiliation(s)
| | | | | | | | - Cheng Liang
- Department of Neurology, The Second Hospital of Lanzhou University, Lanzhou, China
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Roman-Ramos M, Cariati P, Cabello-Serrano A, Garcia-Martin M, Garcia-Medina B. Arthroscopic approach for treating a pigmented villonodular sinovitis of TMJ. A case report. J Clin Exp Dent 2017; 9:e312-e314. [PMID: 28685013 PMCID: PMC5494200 DOI: 10.4317/jced.53114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 06/29/2016] [Indexed: 11/05/2022] Open
Abstract
The present report describes the case of a 29-year-old man referred to our service for TMJ pain and progressive reduction of the mouth opening. Differential diagnostics included rheumatologic diseases, monoarthritis and intraarticular lumps. In this line, a face CT scan and a MRI of TMJ were carried out in order to ensure a proper diagnosis. These tests showed a solid lesion into the joint cavity. In view of that, we decided to perform a diagnostic and therapeutic arthroscopy of TMJ. Histopathological studies confirmed the diagnosis of pigmented villonodular synovitis. The main aim of this report is to describe this rare syndrome with the goal of proposing suitable treatments. Moreover, we highlight the benefits of using arthroscopic procedures in the cases which the tumor is still confined to the joint. As far as we are aware, scientific literature documents only a single case of pigmented villonodular synovitis of TMJ treated with arthroscopic approach. Key words:Arthroscopic approach, pigmented villonodular synovitis, TMJ, mouth opening.
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Affiliation(s)
- Maria Roman-Ramos
- Oral and Maxillofacial surgery resident. Hospital Universitario Virgen de las nieves, Granada, Spain
| | - Paolo Cariati
- Oral and Maxillofacial surgery resident. Hospital Universitario Virgen de las nieves, Granada, Spain
| | | | | | - Blas Garcia-Medina
- Maxillofacial Surgeon. Hospital Universitario Virgen de las nieves, Granada, Spain
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Vellutini EDAS, Alonso N, Arap SS, Godoy LFS, Souza E Souza RAD, Mattedi RL, de Oliveira MF. Functional Reconstruction of Temporomandibular Joint after Resection of Pigmented Villonodular Synovitis with Extension to Infratemporal Fossa and Skull Base: A Case Report. Surg J (N Y) 2016; 2:e78-e82. [PMID: 28824995 PMCID: PMC5553471 DOI: 10.1055/s-0036-1587693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 07/11/2016] [Indexed: 01/28/2023] Open
Abstract
Introduction
Pigmented villonodular synovitis (PVNS) is a benign but aggressive lesion arising from sinovia. The temporomandibular joint (TMJ) is hardly ever involved.
Methods
We describe a case of PVNS arising in the left TMJ involving infratemporal fossa soft tissue and the skull base; we also present the reconstruction.
Results
A 37-year-old woman had progressive mandibular swelling for 6 months. Computed tomography of the skull revealed an osteolytic lesion in the left TMJ, involving the upper mandible, condyle, and glenoid fossa and extending to the infratemporal fossa and fossa media through a defect in temporal bone. Surgical management included a left pterional craniotomy to reach the temporal skull base and resect the intracranial tumor and a facial approach with partial left mandibulectomy and resection of left condyle, glenoid fossa, and tumor removal in infratemporal fossa. Mandible function was restored with prosthetic reconstruction of the condyle. She progressively started to eat solid foods after 3 months, becoming increasingly functional and asymptomatic. At 30 months' follow-up, she had no sign of tumoral recurrence and showed asymptomatic and normal TMJ function.
Conclusion
PVNS should be considered in the differential diagnosis of bone neoplasms affecting young patients. In such cases, radical excision is mandatory and TMJ prosthesis for local reconstruction may be used to preserve functionality.
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Affiliation(s)
| | - Nivaldo Alonso
- Department of Plastic Surgery, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Sérgio Samir Arap
- Department of Head and Neck Surgery, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Pigmented Villonodular Synovitis of the Temporomandibular Joint: A Unique Presentation. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e674. [PMID: 27200236 PMCID: PMC4859233 DOI: 10.1097/gox.0000000000000658] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 02/11/2016] [Indexed: 12/04/2022]
Abstract
Pigmented villonodular synovitis (PVNS) is a rare and benign proliferative disorder of synovium with potentially locally aggressive growth and invasion of the bone. Occurring within the joints, tendon sheaths, and bursae, it is most commonly a monoarticular disease affecting large joints. In particular, most cases of PVNS occur in the knee. PVNS of the temporomandibular joint (TMJ) is a highly rare disorder, with approximately 60 cases reported. Herein, we present a unique case of an elderly male presenting with ear pain and subsequently diagnosed with PVNS of the TMJ with a history of trauma to the area. Initial imaging of the TMJ and the surrounding region looked concerning for invasive and/or malignant disease, but an open biopsy confirmed PVNS.
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Ye ZX, Yang C, Chen MJ, Abdelrehem A. A novel approach to neoplasms medial to the condyle: a condylectomy with anterior displacement of the condyle. Int J Oral Maxillofac Surg 2015; 45:427-32. [PMID: 26748864 DOI: 10.1016/j.ijom.2015.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Revised: 09/28/2015] [Accepted: 11/23/2015] [Indexed: 10/22/2022]
Abstract
Resecting neoplasms involving the infratemporal space has a high risk of damaging critical nerves and vessels, in addition to joint form and function. The purpose of this study was to introduce a novel approach to lesions medial to the condyle, which comprises a condylectomy with anterior displacement of the condyle. The indications evaluated using digital surgical simulation, the critical surgical technique, and the preliminary clinical effects are presented here. Five cases underwent this approach between January 2006 and December 2014. The common characteristics of the five masses were (1) that they were non-malignant neoplasms involving the posterior-medial region of the condyle; (2) the upper and lower borders were between the skull base and the lingula, while the anterior border did not exceed the coronoid process. All masses were resected successfully with no damage to any critical nerves or vessels. The average follow-up period was 29.8 months (range 6-56 months). There was no recurrence, secondary deformity, or facial paralysis. The average mouth opening improved from an original 27 mm to 34 mm after surgery. The condyles were well fixed, with no resorption, as shown on computed tomography scans.
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Affiliation(s)
- Z-X Ye
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China
| | - C Yang
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China.
| | - M-J Chen
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China
| | - A Abdelrehem
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China; Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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