Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Neurosurgery, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Jan;131(1):16-26. doi: 10.1016/j.oooo.2020.08.013. Epub 2020 Aug 18.
The aim of this study was to retrospectively analyze the clinical characteristics, surgical treatment, and prognosis of patients with diffuse-type tenosynovial giant cell tumor (D-TGCT) involving the temporomandibular joint (TMJ) and the skull base.
A retrospective study was performed in patients with D-TGCT involving the TMJ and the skull base at our institute from April 2009 to August 2018. Data on clinical characteristics, surgical treatment, and prognosis were collected and analyzed. A literature search on D-TGCT involving the TMJ was conducted and the data analyzed.
The study included 22 patients (14 males and 8 females), with an average age of 44 years. The main symptoms were headache and hearing limitation, accompanied by a swelling in the TMJ area. Magnetic resonance imaging (MRI) showed low signals on T1- and T2-weighted images. All lesions were completely removed. Temporal bone flap, titanium mesh, and temporal muscle flap were used for reconstruction. The recurrence rate was 4.5%. In the literature, 115 cases were reported. Surgery alone was performed in 88 cases; postoperative radiotherapy was performed in 19 cases; the tumor recurrence rates were 9.1% and 15.8% for the 2 procedures, respectively. All patients were alive at the end of the follow-up period.
D-TGCT involving the TMJ and the skull base is a locally aggressive but benign lesion necessitating complete resection and has a good prognosis.
本研究旨在回顾性分析累及颞下颌关节（TMJ）和颅底的弥漫型腱鞘巨细胞瘤（D-TGCT）患者的临床特征、手术治疗和预后。
本研究回顾性分析了 2009 年 4 月至 2018 年 8 月在我院接受累及 TMJ 和颅底的 D-TGCT 治疗的患者。收集并分析了患者的临床特征、手术治疗和预后数据。同时对累及 TMJ 的 D-TGCT 进行了文献检索和数据分析。
本研究共纳入 22 例患者（男 14 例，女 8 例），平均年龄 44 岁。主要症状为头痛和听力障碍，伴有 TMJ 区肿胀。磁共振成像（MRI）显示 T1 和 T2 加权图像上的低信号。所有病变均完全切除。采用颞骨瓣、钛网和颞肌瓣进行重建。复发率为 4.5%。文献中报道了 115 例病例。单纯手术治疗 88 例，术后放疗 19 例；2 种治疗方法的肿瘤复发率分别为 9.1%和 15.8%。所有患者在随访结束时均存活。
累及 TMJ 和颅底的 D-TGCT 是一种局部侵袭性但良性病变，需要完全切除，预后良好。
