J Oral Facial Pain Headache. 2017;31(2):180-185. doi: 10.11607/ofph.1672.
This article describes the case history of a 59-year-old female patient who sought advice for temporomandibular joint (TMJ) pain and sounds but who was actually diagnosed with a primary lung cancer with metastasis to the TMJ. The patient had a history of TMJ pain and deflection in jaw movement that progressively worsened over a few months and did not improve with the usual standard of care treatment provided by an orofacial pain practitioner. Magnetic resonance and computed tomography (CT) prescribed at a tertiary clinic showed an osteolytic bone mass within the right TMJ condyle. The neoformation was surgically removed and histologic assessment revealed it was a metastasis of a silent lung carcinoma. Thorax CT confirmed the presence of a formation within the apical segment of the right lung superior lobe. While this scenario of a silent lung cancer metastasis to the TMJ condyle mimicking classical symptoms of temporomandibular disorders (TMD) is rare, it does indicate that the path to differential diagnosis is often difficult in TMD and orofacial pain patients, and that practitioners managing such patients should be aware of the variegate spectrum of possible TMD-mimicking conditions to avoid dangerous diagnostic delays.
本文描述了一位 59 岁女性患者的病史，她因颞下颌关节（TMJ）疼痛和弹响寻求建议，但实际上被诊断为原发性肺癌伴 TMJ 转移。该患者有 TMJ 疼痛和下颌运动偏斜的病史，在几个月内逐渐加重，且常规口腔颌面疼痛治疗并未改善。在一家三级诊所开的磁共振和计算机断层扫描（CT）显示右侧 TMJ 髁突内有溶骨性骨块。新形成的组织被手术切除，组织学评估显示为无声肺癌的转移。胸部 CT 证实右上肺尖段有一个形成物。虽然这种无声肺癌转移至 TMJ 髁突、模拟经典颞下颌关节紊乱（TMD）症状的情况很少见，但它确实表明，在 TMD 和口腔颌面疼痛患者中，鉴别诊断的途径往往很困难，管理此类患者的医生应该了解 TMD 模拟疾病的多样化谱，以避免危险的诊断延误。
