Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-28T02:22:39.908Z Has data issue: false hasContentIssue false
  • English
  • Français

Extra-articular pigmented villonodular synovitis of the temporomandibular joint

Published online by Cambridge University Press:  29 June 2007

Louis T. C. Chow ,
S. M. Kumta  and
Walter W. K. King
Louis T. C. Chow*
Affiliation:
Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, Hong Kong.
S. M. Kumta
Affiliation:
Department of Orthopaedics and Traumatology, Prince of Wales Hospital, Hong Kong.
Walter W. K. King
Affiliation:
Department of Surgery, Prince of Wales Hospital, Hong Kong.
*
Address for correpondence: Dr Louis T. C. Chow, Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, 30–32 Ngan Shing Street, Shatin, Hong Kong. Fax: (852)-2637-6274
Get access Rights & Permissions [Opens in a new window]

Abstract

Pigmented villonodular synovitis, a benign but locally destructive fibrohistiocytic proliferative lesion involving tendon sheaths, bursae and diarthrodial joints, is distinctly rare in the temporomandibular joint. We report one such case occurring in a 42-year-old housewife who presented with a progressively enlarging right zygomatic mass for six months. On exploration, an orange-brown firm mass, 5 × 3 × 2 cm, was seen adherent to the lateral aspect of the capsule of the right temporomandibular joint, and eroding into the inferior aspect of the right temporal bone and part of the mandibular condyle. The mass was completely excised. Pathological examination showed features typical of those of pigmented villonodular synovitis and the lesion was entirely extra-articular in location. The patient remained well with no evidence of local recurrence two years after operation. Review of the literature and careful analysis of the clinicopathological features showed that the vast majority of the reported cases of pigmented villonodular synovitis of the temporomandibular joint belonged to the extraarticular variant, which is associated with a more aggressive local infiltrative behaviour and higher rate of local recurrence than the localized type. The recommended treatment for this condition is therefore wide local excision, aiming to remove the lesion as completely as possible without producing severe disability for the patient.

Keywords

Temporomandibular jointSynovitis, pigmented villonodular
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 112 , Issue 2 , February 1998 , pp. 182 - 185
Copyright
Copyright © JLO (1984) Limited 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barnard, J. D. W. (1975) Pigmented villonodular synovitis in the temporomandibular joint: a case report. British Journal of Oral Surgery 13: 183–187.Google Scholar
Curtin, H. D., Williams, R., Gallia, L., Meyers, E. (1983) Pigmented villonodular synovitis of the temporomandibular joint. Computerized Radiology 7: 257–260.CrossRefGoogle ScholarPubMed
Dawiskiba, S., Eriksson, L., Elner, A., Johansen, C. C., Hansson, L. G., Westesson, P. L. (1989) Diffuse pigmented villonodular synovitis of the temporomandibular joint diagnosed by fine needle aspiration cytology. Diagnostic Cytopathology 5: 301–304.CrossRefGoogle ScholarPubMed
Dinerman, W. S., Myers, E. N. (1977) Pigmented villonodular tenosynovitis of the temporomandibular joint: a case report. Transactions of the American Academy of Ophthalmology and Otolaryngology 84: 132–135.Google Scholar
Dorwart, R. H., Genant, H. K., Johnston, W. H., Morris, J. M. (1984) Pigmented villonodular synovitis of synovial joints: Clinical, pathologic and radiologic features. American Journal of Roentgenology 143: 877–885.CrossRefGoogle ScholarPubMed
Eisig, S., Dorfman, H. D., Cusamano, R. J., Kantrowitz, A. B. (1992) Pigmented villodular synovitis of the temporomandibular joint: case report and review of the literature. Oral Surgery, Oral Medicine, Oral Pathology 73: 328–333.CrossRefGoogle ScholarPubMed
Enzinger, F. M., Weiss, S. W. (1995) Benign tumors and tumorlike lesions of synovial tissue. In Soft Tissue Tumors. 3rd Edition. C. V. Mosby: St. Louis, pp 735–755.Google Scholar
Franchi, A., Frosini, P., Santoro, R. (1994) Pigmented villonodular synovitis of the temporomandibular joint: report of a case. Journal of Laryngology and Otology 108: 166–167.CrossRefGoogle ScholarPubMed
Gallia, L. J., Johnson, J. T., Myers, E. N. (1982) Pigmented villonodular synovitis of the temporomandibular joint: a case report. Otolaryngology – Head and Neck Surgery 90: 691–695.Google Scholar
Geiger, S., Pesch, H. J. (1980) Synovitis pigmentosa villonodularis, eine saltene Kiefergelenkerkrankung. Fortschritte der Kieferund Gesichts-Chirurgie 25: 129–132.Google Scholar
Jaffe, H. L., Lichtenstein, L., Sutro, C. J. (1941) Pigmented villonodular synovitis, bursitis, and tenosynovitis: a discussion of the synovial and bursal equivalents of the tenosynovial lesions commonly denoted as xanthoma, xanthogranuloma, giant cell tumor, or myeloplaxoma of the tendon sheath, with some consideration of the tendon sheath lesion itself. Archives of Pathology and Laboratory Medicine 31: 731–765.Google Scholar
Lapayowker, M. S., Miller, W. T., Levy, W. M., Harwick, R. D. (1973) Pigmented villonodular synovitis of the temporomandibular joint. Radiology 108: 313–316.CrossRefGoogle Scholar
Makek, M., Drommer, M. (1978) Localized nodular synovitis of the temporomandibular joint: a case report. Journal of Maxillofacial Surgery 6: 302–305.Google Scholar
Miyamoto, Y., Tani, T., Hamaya, K. (1977) Pigmented villonodular synovitis of the temporomandibular joint: case report. Plastic Reconstructive Surgery 59: 283–286.Google Scholar
Ohira, Y. (1994) Pigmented villonodular synovitis (PVS) of the temporomandibular joint (TMJ): A case report. Otolaryngology - Head and Neck Surgery – Tokyo 66: 348–352.Google Scholar
O'Sullivan, T. J., Alport, E. C., Whiston, H. G. (1984) Pigmented villonodular synovitis of the temporomandibular joint. Journal of Otolaryngology 13: 123–126.Google ScholarPubMed
Raibley, S. O. (1977) Villonodular synovitis with synovial chondromatosis. Oral Surgery, Oral Medicine, Oral Pathology 44: 279–284.CrossRefGoogle ScholarPubMed
Rickerts, R. R., Shapiro, M. J. (1982) Pigmented villonodular synovitis of the temporomandibular joint. Otolaryngology – Head and Neck Surgery 90: 668–670.CrossRefGoogle Scholar
Schwartz, H. S., Unni, K. K., Pritchard, D. J. (1989) Pigmented villonodular synovitis: a retrospective review of affected large joints. Clinical Orthopaedics and Related Research 247: 243–255.CrossRefGoogle Scholar
Shapiro, S., Kessler, S., McMenomey, S. O. (1996) Pathologic quiz case 1. Archives of Otolaryngology - Head and Neck Surgery 122: 194, 196.Google ScholarPubMed
Syed, A., Van Hasselt, C. A., To, K. F. (1993) Pigmented villonodular synovitis of the temporomandibular joint. Journal of Laryngology and Otology 107: 853–854.CrossRefGoogle ScholarPubMed
Takagi, M., Ishikawa, G. (1981) Simultaneous villonodular synovitis and synovial chondromatosis of the temporomandibular joint: report of a case. Journal of Oral Surgery 39: 699–701.Google Scholar
Tanaka, K., Suzuki, M., Nameki, H., Sugiyama, H. (1997) Pigmented villonodular synovitis of the temporomandibular joint. Archives of Otolaryngology – Head and Neck Surgery 123: 536–539.Google Scholar
Youssef, R. E., Roszkowski, M. J., Richter, K. J. (1996) Pigmented villonodular synovitis of the temporomandibular joint. Journal of Oral and Maxillofacial Surgery 54: 224–227.CrossRefGoogle ScholarPubMed
Yu, G. H., Staerkel, G. A., Kershisnik, M. M., Varma, D. G. K. (1997) Fine-needle aspiration of pigmented villonodular synovitis of the temporomandibular joint masquerading as a primary parotid gland lesion. Diagnostic Cytopathology 16: 47–50.Google Scholar