Computed Tomography Imaging Study of a Diffuse Tenosynovial Giant Cell Tumour in the Temporomandibular Joint.

Abstract

Objective: To provide diagnostic and therapeutic references by analysing clinical features and CT imaging data of diffuse tenosynovial giant cell tumours (D-TSGCT) in the temporomandibular joint (TMJ).

Methods: Patients who were diagnosed with a D-TSGCT in the TMJ through histopathological examination and underwent surgical treatment at Peking University Stomatological Hospital from April 2013 to October 2022 were included in the present study. The study retrospectively analysed and summarised patients' clinical and radiological features, the latter including osseous erosion, invasion of surrounding tissues and imaging characteristics.

Results: This study included 31 patients with a D-TSGCT in the TMJ (16 men, 15 women; median age 46 years). All patients underwent surgical treatment, with 51.6% receiving postoperative supplementary radiotherapy. The recurrence rate was 19.4% over a 3- to 12-year follow-up period. Imaging revealed extra-articular extension in 83.9% of cases, and 93.5% of cases showed bone involvement (condyle 48.4%, glenoid fossa 77.4%). Other features included articular eminence destruction (67.7%), ill-defined masses with calcification (51.6%), marginal enhancement (26.9%) and periosteal reaction (9.7%).

Conclusion: The imaging features showed that D-TSGCT in the TMJ is an aggressive and expansive neoplasm with significant bone invasion. The recurrence patterns further support its intermediate-type biological behaviour. Computed tomography images play a critical role in diagnosis, treatment planning and prognosis assessment.