Pigmented villonodular synovitis of the temporomandibular joint with intracranial extension: a case and literature review.
Pigmented villonodular synovitis (PVNS) is a benign, yet locally aggressive proliferative lesion most commonly found in joints of the long bones; it rarely presents in the temporomandibular joint (TMJ). The authors report a case of PVNS involving the TMJ and review similar cases reported in the English literature. This is the first case of PVNS with long-term follow-up of 11 years to include imaging studies. A 36-year-old male with symptoms suggestive of a temporomandibular disorder (TMD) presented with a progressive preauricular/parotid swelling and restricted mandibular range of motion. Imaging suggested a lesion with an aggressive course due to tissue displacement and destruction proximal to the lesion. A multidisciplinary team performed complete excision of the lesion with immediate reconstruction. PVNS often presents with similar symptoms to a TMD, but must be distinguished from symptomatic TMD as it can be highly destructive. Owing to its aggressive nature and potential for recurrence, complete and early extirpation and long-term follow-up with advanced imaging is indicated.
Herman
C R
CR
University of Minnesota, School of Dentistry, Division of TMD and Orofacial Pain, Department of Diagnostic and Biological Sciences, Minneapolis, Minnesota 55455, USA. herm0024@umn.edu
Swift
J Q
JQ
Schiffman
E L
EL
D000328:Adult; D035301:Cranial Fossa, Middle / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D004433:Earache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019291:Skull Base / Q000473:pathology / Q000601:surgery; D013586:Synovitis, Pigmented Villonodular / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D013705:Temporomandibular Joint Disorders / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed