China Journal of Oral and Maxillofacial Surgery ›› 2019, Vol. 17 ›› Issue (4): 359-363.doi: 10.19438/j.cjoms.2019.04.017

• Clinical Reports • Previous Articles     Next Articles

CT and MRI features of diffuse tenosynovial giant cell tumor in temporomandibular joint

CHEN Pei-qian1, TAO Xiao-feng1, ZHANG Chun-ye2, ZHU Ling1   

  1. 1.Department of Radiology;
    2.Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2019-01-30 Revised:2019-04-23 Online:2019-07-20 Published:2019-08-12

Abstract: PURPOSE: To analyze the clinical and imaging features of diffuse tenosynovial giant cell tumor (D-TSGCT) in temporomandibular joint (TMJ) space, in order to improve the diagnostic accuracy of the disease. Methods: Clinical features, CT and MRI findings of 23 cases confirmed by operation and pathology from November 2015 to May 2018 were analyzed retrospectively. Results: The main clinical symptoms in 23 cases were mass in preauricular region with pain. Maxillofacial CT showed mass in TMJ area,the average CT value was (72±20.49)HU,the average enhanced CT value was (125.3±22.68)HU. Nine cases (39.1%) had irregular or circular lower density lesions in the mass, but no enhancement was found after enhancement. Calcification was found in 14 cases (60.1%), widened articular space was found in 16 cases (69.6%), condylar bone destruction occurred in 14 cases (60.1%),bone destruction of articular fossa occurred in 17 cases (73.9%), tympanic destruction occurred in 6 cases(26.1%). Six cases (66.7%) showed iso-and hypo-intense signal on T1WI,hyper-and hypo-intense on T2WI; two cases(22.2%) showed hypo-intense signal on T1WI and hypo-intense on T2WI; one case(11.1%) showed iso-intense signal on T1WI and hypo-intense on T2WI. Cystic lesions were found in 5 cases (55.6%). Conclusions: The main clinical symptoms of D-TSGCT in TMJ space is mass in preauricular region with pain. Imaging features are high density of masses with calcifications, enhancement obviously after contrast injection and destruction of condyle, articular fossa and tympanic walls. T2WI shows characteristic low signal, cystic lesions may occur. Combined use of enhanced CT and MRI can significantly improve the diagnostic accuracy of D-TSGCT in TMJ.

Key words: Diffuse tenosynovial giant cell tumor, Temporomandibular joint, CT, MRI

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