title: Treatment of temporomandibular joint ganglion cyst.
abstract: Ganglion cysts of the temporomandibular joint are very rare and always misdiagnosed as synovial cyst, parotid gland tumor, or other cystic lesions. They present with pain, swelling, or dysfunction. Image studies could facilitate to identify the tumor mass from the adjacent soft tissue, but a definitive diagnosis could be made from the pathologic report.A 59-year-old woman presented to the clinics with a chief complaint of a painless swelling mass in the right preauricular region of 3-month duration. Computed tomography was performed, which showed a small radiolucent lesion adjacent to the right condyle. Local excision was performed, and the specimen was sent for histologic examination.Microscopic examination showed a cystic space walled by dense fibrous connective tissue without epithelial or endothelial lining. Immunohistochemical staining of these lining cells showed positivity for vimentin and negativity for cytokeratin. These findings were consistent with the diagnosis of ganglion cyst.Ganglion cysts present as unilobulate or multilobulate cysts that arise from the collagenous tissue and is filled with highly viscous fluid. It does not communicate with the joint cavity. In contrast, synovial cyst is a true cyst lined by cuboidal or flattened cells from the synoviocytes and is filled with gelatinous fluid. It may or may not communicate with the joint cavity. Excision is the treatment of choice of symptomatic cystic lesions. Incomplete excision of these lesions may cause further recurrence or infection. Thus, injection of hydrocortisone or aspiration may be considered as an alternative management.
authors.affiliation: Department of Plastic Surgery, China Medical University Hospital, School of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Chao-I
authors.initials: CI
authors.lastname: Wu
authors.forename: Ka-Wai
authors.initials: KW
authors.lastname: Liu
authors.forename: Yung-Chang
authors.initials: YC
authors.lastname: Hsu
authors.forename: I-Ping
authors.initials: IP
authors.lastname: Chiang
authors.forename: Sophia Chia-Ning
authors.initials: SC
authors.lastname: Chang
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D000074402:Synovectomy; D013581:Synovial Cyst / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013583:Synovial Membrane / Q000000981:diagnostic imaging / Q000473:pathology; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed