Wang Ji-Gang, Liu Jingwei, He Bing, Gao Ling, Zhang Lijuan, Liu Jihua
Associate Chief Physician and Postdoctoral Research Fellow, Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Resident, Department of Pediatric Surgery, Qilu Hospital, Shandong University, Jinan, China.
J Oral Maxillofac Surg. 2019 May;77(5):1022.e1-1022.e39. doi: 10.1016/j.joms.2019.01.025. Epub 2019 Jan 29.
Diffuse tenosynovial giant cell tumor (TGCT) of the temporomandibular joint (TMJ) is rare. The aim of the present study was to summarize the clinical, radiologic, and pathologic features of this tumor.
Nine cases of TGCT in the TMJ region were examined. All available radiologic and pathologic documents were carefully reviewed. These cases were grouped into 3 types according to the radiologic features: bone-centered type, intraosseous type, and soft tissue type. Cases reported in the literature were reviewed to better summarize the clinical characteristics.
TGCTs in the TMJ region showed some special radiologic and pathologic features. Radiologically, the lesion could be centered in the craniofacial bone or centered in the surrounding soft tissue. Four cases were categorized as the bone-centered type, 1 was categorized as the intraosseous type, and 4 were categorized as the soft tissue type. Pathologically, epithelioid mononuclear cells with abundant eosinophilic cytoplasm and eccentric nuclei were observed in all cases. Chondroid metaplasia was noted in 8 cases. Some areas were similar to giant cell reparative granuloma and chondroblastoma. All patients who underwent complete tumor resection showed no evidence of recurrence at follow-up. Of the 93 reported cases, only 5 developed postoperative recurrence and distant metastasis.
TGCTs of the TMJ region share similar radiologic and pathologic features as other tumors, which indicates the TGCT might be a special entity within a spectrum of diseases.
颞下颌关节（TMJ）弥漫性腱鞘巨细胞瘤（TGCT）较为罕见。本研究旨在总结该肿瘤的临床、放射学及病理学特征。
对9例TMJ区域的TGCT病例进行检查。仔细查阅所有可用的放射学和病理学资料。根据放射学特征将这些病例分为3型：骨中心型、骨内型和软组织型。回顾文献报道的病例以更好地总结临床特征。
TMJ区域的TGCT具有一些特殊的放射学和病理学特征。放射学上，病变可位于颅面骨中心或周围软组织中心。4例为骨中心型，1例为骨内型，4例为软组织型。病理学上，所有病例均观察到具有丰富嗜酸性细胞质和偏心核的上皮样单核细胞。8例可见软骨化生。部分区域类似于巨细胞修复性肉芽肿和成软骨细胞瘤。所有接受肿瘤完整切除的患者在随访中均无复发迹象。在93例报道的病例中，仅5例发生术后复发和远处转移。
TMJ区域的TGCT与其他肿瘤具有相似的放射学和病理学特征，这表明TGCT可能是一系列疾病中的一个特殊实体。
