Yokoyama Junkichi, Yoshimoto Hitoshi, Ito Shin, Ohba Shinichi, Fujimaki Mitsuhisa, Ikeda Katsuhisa, Yazawa Masaki, Fujimiya Nozomi, Hanaguri Makoto
Department of Otolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan.
Case Rep Oncol. 2011 Feb 14;4(1):74-81. doi: 10.1159/000324640.
We present a case involving a late diagnosis of chondroblastoma of the temporal skull base involving the temporomandibular joint (TMJ). Following an initial misdiagnosis and unsuccessful treatment over a period of 5 years, the patient was referred to our department for further evaluation and possible surgical intervention for occlusal abnormalities, trismus, clicking of the TMJ, and hearing impairment. Based on preoperative immunochemical studies showing positive reaction of multinucleated giant cells for S-100 protein, the final diagnosis was chondroblastoma. The surgical approach - postauricular incision and total parotidectomy, with complete removal of the temporal bone, including the TMJ via the extended middle fossa - was successful in preserving facial nerves and diminishing clinical manifestations. This study highlights a misdiagnosed case in an effort to underline the importance of medical examinations and accurate differential diagnosis in cases involving any tumor mass in the temporal bone.
我们报告一例涉及颞骨颅底软骨母细胞瘤并累及颞下颌关节(TMJ)的病例,该病例诊断较晚。在最初误诊并经过5年的治疗均未成功后,患者因咬合异常、牙关紧闭、TMJ弹响和听力障碍被转诊至我科进行进一步评估及可能的手术干预。基于术前免疫化学研究显示多核巨细胞对S-100蛋白呈阳性反应,最终诊断为软骨母细胞瘤。手术方法——耳后切口及全腮腺切除术,通过扩大的中颅窝完全切除颞骨,包括TMJ——成功保留了面神经并减轻了临床表现。本研究强调了一例误诊病例,旨在突出在涉及颞骨任何肿瘤肿块的病例中进行医学检查和准确鉴别诊断的重要性。