Hohlweg-Majert Bettina, Metzger Marc C, Böhm Joachim, Muecke Thomas, Schulze Dirk
Department of Oral and Maxillofacial Surgery, Technical University Munich, Munich, Germany.
J Magn Reson Imaging. 2008 Nov;28(5):1251-7. doi: 10.1002/jmri.21581.
Synovial chondromatosis of the joint occurs mainly in teenagers and young adults. Only 3% of these neoplasms are located in the head and neck region. Synovial chondromatosis of the temporomandibular joint is therefore a very rare disorder. Therefore, developing a working, histological confirmation is required for differential diagnosis. In this case series, the outcome of histological investigation and imaging techniques are compared. Based on clinical symptoms, five cases of suspected synovial chondromatosis of the temporomandibular joint are presented. In each of the subjects, the diagnosis was confirmed by histology. Specific imaging features for each case are described. The tomography images were compared with the histological findings. All patients demonstrated preauricular swelling, dental midline deviation, and limited mouth opening. Computer-assisted surgery was performed. Histology disclosed synovial chondromatosis of the temporomandibular joint in four cases. The other case was found to be a developmental disorder of the tympanic bone. The diagnosis of synovial chondromatosis of the temporomandibular joint can only be based on histology. Clinical symptoms are too general and the available imaging techniques only show nonspecific tumorous destruction, infiltration, and/or residual calcified bodies, they are only for advanced cases. A rare developmental disorder of the tympanic bone--persistence of foramen of Huschke--has to be differentiated.
关节滑膜软骨瘤病主要发生于青少年和青年。这些肿瘤仅有3%位于头颈部区域。因此，颞下颌关节滑膜软骨瘤病是一种非常罕见的疾病。所以，进行有效的组织学确诊对于鉴别诊断是必要的。在这个病例系列中，对组织学检查结果和影像学技术结果进行了比较。基于临床症状，呈现了5例疑似颞下颌关节滑膜软骨瘤病的病例。在每个病例中，诊断均通过组织学得到证实。描述了每个病例的具体影像学特征。将断层扫描图像与组织学检查结果进行了比较。所有患者均表现为耳前肿胀、牙中线偏移和张口受限。实施了计算机辅助手术。组织学检查在4例中发现颞下颌关节滑膜软骨瘤病。另一例被发现是鼓骨的发育障碍。颞下颌关节滑膜软骨瘤病的诊断只能基于组织学。临床症状过于笼统，现有的影像学技术仅显示非特异性的肿瘤性破坏、浸润和/或残留的钙化体，它们仅适用于晚期病例。必须鉴别一种罕见的鼓骨发育障碍——胡施克孔持续存在。
