A Case of Tenosynovial Giant Cell Tumor, Localized Type of the Temporomandibular Joint

• Published in: JIBI INKOKA TEMBO Vol. 66; no. 5; pp. 217 - 223
• Main Authors: Shiraki, Yuichiro, Nagaoka, Masato, Kawasaki, Takeshi, Kobayashi, Toshiki, Yui, Ryosuke
• Format: Journal Article
• Language: Japanese
• Published: Society of Oto-rhino-laryngology Tokyo 15.10.2023; 耳鼻咽喉科展望会
• Subjects: temporomandibular joint tumor; tenosynovial giant cell tumour; wide excision; びまん型腱滑膜巨細胞腫; 広範切除; 顎関節腫瘍
• ISSN: 0386-9687; 1883-6429
• DOI: 10.11453/orltokyo.66.5_217

A diffuse-type tenosynovial giant cell tumor is a benign bone and soft tissue tumor arising from the joint synovium or tendon sheath, and is a subclass of tenosynovial giant cell tumors. It occurs mainly in large joints such as the knee joint, and occurs rarely in the temporomandibular joint. In this case, a patient visited a previous doctor with the chief complaints of left temporomandibular joint pain, trismus, and headache. Giant cell reparative granuloma was suspected based upon CT-guided biopsy, and she was referred to our hospital for treatment. Imaging tests were also performed at our hospital, but no definitive diagnosis was made. An initial surgical resection was performed for the purpose of diagnosis and treatment, and the pathological results and site of origin led to the diagnosis of diffuse-type tenosynovial giant cell tumor. Recurrence of the headache was subsequently observed, and it was thought to be due to residual lesions. Although there was a possibility that postoperative functional impairment remained, from the viewpoint of local control, a second surgical excision was performed using wide excision. The recurrence rate of giant cell reparative granuloma is 10–17% after sufficient curettage and resection of the lesion, but diffuse-type tenosynovial giant cell tumor has a high recurrence rate of 25–46%. Wide excision is preferable from the perspective of local control, although there remains the possibility that later functional impairment may occur.