CT imaging features of diffuse tenosynovial giant cell tumor of temporomandibular joint

doi:10.7518/hxkq.2018.03.010

Abstract

Abstract:

Objective This study aimed to investigate the characteristic features of CT images of diffuse tenosynovial giant cell tumor (D-TSGCT) from the temporomandibular joint (TMJ) to understand CT imaging diagnosis of the disease. Methods CT images and clinical information from 10 patients with D-TSGCT of TMJ were recruited for retrospective analysis from March 2013 to March 2017 in Peking University Hospital of Stomatology. All cases were treated by surgery and confirmed by pathology. Results CT scan demonstrated hyperdense soft-tissue masses and various kinds of calcification in all of the 10 subjects. Contrast-enhanced scan exhibited obvious enhancement in six patients. Bone destruction of the mandibular condyles and skull base was found in seven and six subjects, respectively. Conclusion CT appearance of D-TSGCT of the TMJ is characterized by hyperdense soft tissue with calcification, further enhancement in contrast-enhanced scan, and bone destruction in the mandibular condyles and skull base in some cases.

Key words: temporomandibular joint, tumor, diffuse tenosynovial giant cell tumor, CT imaging

CLC Number:

R782.6

Weiyu Mao, Muqing Liu, Kaiyuan Fu. CT imaging features of diffuse tenosynovial giant cell tumor of temporomandibular joint[J]. West China Journal of Stomatology, 2018, 36(3): 282-286.

Figures/Tables 4

References 24

[1]	Yu GH, Staerkel GA, Kershisnik MM, et al.Fine-needle aspiration of pigmented villonodular synovitis of the tem-poromandibular joint masquerading as a primary parotid gland lesion[J]. Diagn Cytopathol, 1997, 16(1): 47-50.
[2]	Asano N, Yoshida A, Kobayashi E, et al.Multiple metas-tases from histologically benign intraarticular diffuse-type tenosynovial giant cell tumor: a case report[J]. Hum Pathol, 2014, 45(11): 2355-2358.
[3]	Stryjakowska KK, Martel M, Sasaki CT.Pigmented villono-dular synovitis of the temporomandibular joint: differential diagnosis of the parotid mass[J]. Auris Nasus Larynx, 2005, 32(3): 309-314.
[4]	Aoyama S, Iwaki H, Amagasa T, et al.Pigmented villono-dular synovitis of the temporomandibular joint: differential diagnosis and case report[J]. Br J Oral Maxillofac Surg, 2004, 42(1): 51-54.
[5]	Hu Y, Kuang B, Chen Y, et al.Imaging features for diffuse-type tenosynovial giant cell tumor of the temporomandibu-lar joint: a case report[J]. Medicine (Baltimore), 2017, 96(26): e7383.
[6]	Jaffe HL.Pigmented villonodular synovitis, bursitis and tenosynovitis[J]. Arch Pathol, 1941, 31(6): 731-765.
[7]	Lapayowker MS, Miller WT, Levy WM, et al.Pigmented villonodular synovitis of the temperomandibular joint[J]. Radiology, 1973, 108(2): 313-316.
[8]	Ma X, Shi G, Xia C, et al.Pigmented villonodular synovitis: a retrospective study of seventy five cases (eighty one joints)[J]. Int Orthop, 2013, 37(6): 1165-1170.
[9]	Bunting D, Kampa R, Pattison R.An unusual case of pig-mented villonodular synovitis after total knee arthroplasty[J]. J Arthroplasty, 2007, 22(8): 1229-1231.
[10]	Le WJ, Li MH, Yu Q, et al.Pigmented villonodular syno-vitis of the temporomandibular joint: CT imaging findings[J]. Clin Imaging, 2014, 38(1): 6-10.
[11]	Kim KW, Han MH, Park SW, et al.Pigmented villonodular synovitis of the temporomandibular joint: MR findings in four cases[J]. Eur J Radiol, 2004, 49(3): 229-234.
[12]	Somerhausen NS, Fletcher CD.Diffuse-type giant cell tumor: clinicopathologic and immunohistochemical analysis of 50 cases with extraarticular disease[J]. Am J Surg Pathol, 2000, 24(4): 479-492.
[13]	Cai J, Cai Z, Gao Y.Pigmented villonodular synovitis of the temporomandibular joint: a case report and the literature review[J]. Int J Oral Maxillofac Surg, 2011, 40(11): 1314-1322.
[14]	Murphey MD, Rhee JH, Lewis RB, et al.Pigmented villo-nodular synovitis: radiologic-pathologic correlation[J]. Radio-graphics, 2008, 28(5): 1493-1518.
[15]	Wan JM, Magarelli N, Peh WC, et al.Imaging of giant cell tumour of the tendon sheath[J]. Radiol Med, 2010, 115(1): 141-151.
[16]	孟娟红, 郭玉兴, 罗海燕, 等. 颞下颌关节弥漫型腱鞘巨细胞瘤的诊断与治疗[J]. 北京大学学报(医学版), 2016, 48(6): 1049-1054.
	Meng JH, Guo YX, Luo HY, et al.Diagnosis and treatment of diffuse tenosynovial giant cell tumor arising from temp-oromandibular joints[J]. J Peking Univ (Health Sci), 2016, 48(6): 1049-1054.
[17]	Herman CR, Swift JQ, Schiffman EL.Pigmented villono-dular synovitis of the temporomandibular joint with intra-cranial extension: a case and literature review[J]. Int J Oral Maxillofac Surg, 2009, 38(7): 795-801.
[18]	Chung SM, Janes JM.Diffuse pigmented villonodular syno-vitis of the hip joint. Review of the literature and report of four cases[J]. J Bone Joint Surg Am, 1965, 47: 293-303.
[19]	Darling JM, Glimcher LH, Shortkroff S, et al.Expression of metalloproteinases in pigmented villonodular synovitis[J]. Hum Pathol, 1994, 25(8): 825-830.
[20]	Neale SD, Kristelly R, Gundle R, et al.Giant cells in pig-mented villo nodular synovitis express an osteoclast pheno-type[J]. J Clin Pathol, 1997, 50(7): 605-608.
[21]	Kim IK, Cho HY, Cho HW, et al.Pigmented villonodular synovitis of the temporomandibular joint-computed tomo-graphy and magnetic resonance findings: a case report[J]. J Korean Assoc Oral Maxillofac Surg, 2014, 40(3): 140-146.
[22]	Safaee M, Oh T, Sun MZ, et al.Pigmented villonodular synovitis of the temporomandibular joint with intracranial extension: a case series and systematic review[J]. Head Neck, 2015, 37(8): 1213-1224.
[23]	Murphey MD, Vidal JA, Fanburg-Smith JC, et al.Imaging of synovial chondromatosis with radiologic-pathologic corre-lation[J]. Radiographics, 2007, 27(5): 1465-1488.
[24]	Srinivasan V, Wensel A, Dutcher P, et al.Calcium pyrophos-phate deposition disease of the temporomandibular joint[J]. J Neurol Surg Rep, 2012, 73(1): 6-8.

病例编号	性别	位置	平扫CT值/Hu	增强CT值/Hu	有无钙化	髁突骨质破坏或吸收	颅底骨质异常
1	女	R	68	143	有	无	有
2	女	L	60	125	有	有	有
3	男	L	70	125	有	有	无
4	女	L	137	-	有	有	无
5	男	R	80	-	有	有	有
6	男	R	106	160	有	无	有
7	女	L	60	-	有	有	无
8	女	R	50	117	有	有	无
9	男	R	59	-	有	有	有
10	女	R	68	145	有	无	有