颞下颌关节软骨样腱鞘巨细胞瘤：病例报告
Chondroid Tenosynovial Giant Cell Tumor of the Temporomandibular Joint: A Case Report.
摘要(中文译文)
我们报告一例罕见的软骨样腱鞘巨细胞瘤（TGCT）累及颞下颌关节（TMJ），患者为46岁男性，病变无症状但进行性增大，中心位于TMJ上方颧骨气房道内。因鼻窦炎症状行计算机断层扫描（CT）发现TMJ上方颧骨气房道附近有一膨胀性病变，该病变在16年间未被发现并持续生长，侵蚀颞骨鳞部并延伸至中颅窝硬脑膜。磁共振成像（MRI）显示TMJ内T1和T2低信号、不均匀强化的结节，扩散加权序列上磁敏感伪影提示含铁血黄素沉积，提示为起源于关节窝滑膜盘的软骨样TGCT。采用耳前颞下入路完整切除肿瘤、滑膜盘及邻近受累骨质。下颌骨髁突未受累并得以保留。采用带蒂颞顶筋膜瓣进行重建。一年随访MRI显示无复发，患者咀嚼功能良好且无疼痛。本病例展示了TMJ软骨样TGCT的诊断和手术治疗，强调其缓慢、无症状生长的潜力及其CT表现为原发性颞骨病变的特点。特征性MRI表现有助于诊断，在评估关节窝附近侵蚀性病变时应考虑软骨样TGCT。
Abstract
We present a rare case of a chondroid tenosynovial giant cell tumor (TGCT) involving the temporomandibular joint (TMJ) in a 46-year-old man with an asymptomatic but progressively enlarging lesion centered within the zygomatic air cell tract superior to the TMJ. A computed tomography (CT) scan performed for sinusitis symptoms revealed an expansile lesion near the zygomatic air cell tract above the TMJ, which had grown undetected over 16 years, eroding the squamous temporal bone and extending to the middle fossa dura. Magnetic resonance imaging (MRI) showed T1- and T2-hypointense, heterogeneously enhancing nodules in the TMJ, with susceptibility artifacts on diffusion-weighted sequences indicating hemosiderin staining, suggestive of a chondroid TGCT originating from the synovial disc in the glenoid fossa. A preauricular infratemporal approach enabled complete resection of the tumor, synovial disc, and adjacent affected bone. The mandibular condyle was unaffected and preserved. Reconstruction was performed using a pedicled temporoparietal fascia flap. One-year follow-up MRI showed no recurrence, and the patient experienced successful mastication without pain. This case illustrates the diagnosis and surgical management of chondroid TGCT of the TMJ, emphasizing its potential for slow, asymptomatic growth and its CT appearance of a primary temporal bone lesion. The characteristic MRI features assist in diagnosis, and chondroid TGCT should be considered when evaluating erosive lesions near the glenoid fossa.
如何引用
AMA
Hunter D Stearns, Tanya Rath, Salvatore Lettieri, Nicholas Deep. Chondroid Tenosynovial Giant Cell Tumor of the Temporomandibular Joint: A Case Report.. Cureus. 2026; doi:10.7759/cureus.109971.
APA
Hunter D Stearns, Tanya Rath, Salvatore Lettieri, Nicholas Deep (2026). Chondroid Tenosynovial Giant Cell Tumor of the Temporomandibular Joint: A Case Report.. Cureus. https://doi.org/10.7759/cureus.109971
GB/T 7714
Hunter D Stearns, Tanya Rath, Salvatore Lettieri, Nicholas Deep. Chondroid Tenosynovial Giant Cell Tumor of the Temporomandibular Joint: A Case Report.[J]. Cureus, 2026 doi:10.7759/cureus.109971.
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