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[影响颞下颌关节的肿瘤——文献综述]

[Tumors affecting the temporomandibular joint - a literature review].

作者信息

Schlund Matthias, Roland-Billecart Thomas, Aubert Sébastien, Nicot Romain

机构信息

University Lille, CHU de Lille, service de chirurgie maxillo-faciale et stomatologie, U1008 - Controlled Drug Delivery Systems and Biomaterial, Inserm, 59000 Lille, France.

University Lille, CHU de Lille, service de chirurgie maxillo-faciale et stomatologie, 59000 Lille, France.

出版信息

Bull Cancer. 2020 Nov;107(11):1186-1198. doi: 10.1016/j.bulcan.2020.05.015. Epub 2020 Oct 12.

Abstract

Benign and malign tumors can affect the temporomandibular joint (TMJ) as any other articulation. Nevertheless, TMJ tumors are rare and mostly benign. Their clinical expression is varied including symptomatology similar to TMJ dysfunctional disorders, otologic or neurologic pathologies. In some cases, they remain totally asymptomatic. Hence, diagnosis is difficult since the symptomatology can be misleading with TMJ dysfunctional disorders or otologic disorders wrongly diagnosed. There is thus frequently a long delay between symptoms onset and diagnosis. The great variety of TMJ lesions explains the wide range of possible treatment modalities, mostly based on surgery. We provide here a review of the lesions originating from the TMJ. Tumoral or cystic mandibular lesion affecting the TMJ through local extension will not be discussed. Osteoma, osteoid osteoma, osteoblastoma, chondroma, osteochondroma, chondroblastoma, tenosynovial giant cell tumors, giant cell lesions, non-ossifying fibroma, hemangioma, lipoma or Langerhans cell histiocytosis are all possible diagnosis among the benign tumors found in the TMJ. Pseudotumors include synovial chondromatosis and aneurysmal bone cyst. Finally, malign tumors of the TMJ include mainly sarcomas (osteosarcoma, chondrosarcoma, synovial sarcoma, Ewing sarcoma, and fibrosarcoma), but also multiple myeloma and secondary metastases. We will review the clinical, radiological and histological aspects of each of these lesions. The treatment and the recurrence risk will also be discussed.

摘要

与其他关节一样,良性和恶性肿瘤均可累及颞下颌关节(TMJ)。然而,颞下颌关节肿瘤较为罕见,且大多为良性。其临床表现多样,包括与颞下颌关节功能紊乱性疾病、耳科或神经科疾病相似的症状。在某些情况下,它们完全没有症状。因此,诊断较为困难,因为这些症状可能会与被误诊的颞下颌关节功能紊乱性疾病或耳科疾病相混淆。所以,从症状出现到诊断往往会有很长的延迟。颞下颌关节病变的种类繁多,这解释了可能的治疗方式范围广泛,且大多基于手术。在此,我们对源自颞下颌关节的病变进行综述。通过局部扩展累及颞下颌关节的肿瘤性或囊性下颌骨病变将不在本文讨论范围内。骨瘤、骨样骨瘤、骨母细胞瘤、软骨瘤、骨软骨瘤、成软骨细胞瘤、腱鞘巨细胞瘤、巨细胞病变、非骨化性纤维瘤、血管瘤、脂肪瘤或朗格汉斯细胞组织细胞增多症都是在颞下颌关节发现的良性肿瘤中可能的诊断。假肿瘤包括滑膜软骨瘤病和动脉瘤样骨囊肿。最后,颞下颌关节的恶性肿瘤主要包括肉瘤(骨肉瘤、软骨肉瘤、滑膜肉瘤、尤因肉瘤和纤维肉瘤),但也包括多发性骨髓瘤和继发性转移瘤。我们将综述这些病变各自的临床、放射学和组织学方面。还将讨论治疗方法及复发风险。

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