伴关节盘穿孔的颞下颌关节滑膜软骨瘤1例报告及文献复习

doi:10.13481/j.1671-587x.20200334

吉林大学学报(医学版) ›› 2020, Vol. 46 ›› Issue (03): 639-642.doi: 10.13481/j.1671-587x.20200334

• 临床医学 • 上一篇

伴关节盘穿孔的颞下颌关节滑膜软骨瘤1例报告及文献复习

刘艺萍¹, 孙晓琳¹, 倪世磊², 赵聪², 葛悦², 周延民¹, 李明贺²

1. 吉林大学口腔医院种植科, 吉林长春 130021;
2. 吉林大学口腔医院口腔颌面外科, 吉林长春 130021

收稿日期:2019-08-13 发布日期:2020-06-11
通讯作者: 李明贺,副教授,硕士研究生导师(Tel:0431-88796021,E-mail:87832900@qq.com) E-mail:87832900@qq.com
作者简介:刘艺萍(1995-),女,四川省成都市人,在读医学硕士,主要从事口腔外科学基础和临床方面的研究。
基金资助:
吉林省财政厅青年科研基金资助课题（JCSZ2019378-13）

Synovial chondromatosis of temporomandibular joint with disc perforation: A case report and literature review

LIU Yiping¹, SUN Xiaolin¹, NI Shilei², ZHAO Cong², GE Yue², ZHOU Yanmin¹, LI Minghe²

1. Department of Oral Implantology, Stomatology Hospital, Jilin University, Changchun 130021, China;
2. Department of Oral and Maxillofacial Surgery, Stomatology Hospital, Jilin University, Changchun 130021, China

Received:2019-08-13 Published:2020-06-11

摘要/Abstract

摘要： 目的：分析伴关节盘穿孔的颞下颌关节滑膜软骨瘤（TMJSC）患者的临床表现、发病机制、辅助检查、鉴别诊断和治疗方法，为TMJSC患者的诊疗提供依据。方法：收集1例TMJSC患者的临床资料，并分析诊治过程，并进行相关文献复习。结果：患者，女性，53岁，因发现右侧颞下颌关节（TMJ）偶有压痛1年余入院。计算机断层摄影（CT）检查显示上颌窦壁及关节周围改变，磁共振成像（MRI）可见关节腔弥漫性结节状低、等异常信号，关节腔液体信号影增多，关节间隙增宽。对患者采取开放性手术治疗，切除游离体和病变滑膜，手术顺利完成，术后组织病理学检查结果为滑膜软骨瘤（SC）。随访6个月未见复发。结论：TMJSC诊断应采用组织病理学检测结合CT和MRI辅助检查，手术治疗是有效的治疗手段，病理诊断为诊断TMJSC的金标准。

关键词: 颞下颌关节滑膜软骨瘤, 滑膜软骨瘤, 颞下颌关节, 关节游离体

Abstract: Objective: To analyze the clinical manifestations, pathogenesis, auxiliary examinations, differential diagnosis and treatment methods of the patient with synovial chondromatosis of temporomandibular joint (TMJSC)with disc perforation,and to provide the basis for the diagnosis and treatment of TMJSC patients. Methods: The clinical data of one patient with TMJSC were collected,and the diagnosis and treatment process was analyzed, and the related literatures were reviewed. Results: The female 53-year-old patient was admitted to hospital due to occasional tenderness in the right TMJ for more than 1 year. The computerized tomography (CT)results revealed that the changes could be found around the wall of maxillary sinus and the joint. The magnetic resonance imaging(MRI) results showed the diffused nodular, low and equal signals in the joint cavity, the shadow of fluid signals in the joint cavity was increased, and the joint space was broadened.The open surgery was performed in the patient successfully, including the removal of loose bodies and synovectomy, and the pathology result after opration was synovial chondromatosis(SC). No recurrence was found during 6 months after follow-up. Conclusion: The histopathology examination assisted with CT and MRI should be perfomed in the diagnosis of TMJSC. Surgical treatment is an effective method,and the pathological diagnosis is the gold standard for TMJSC.

Key words: synovial chondromatosis of temporomandibular joint, synovial chondromatosis, temporomandibular joint, joint loose body

中图分类号:

R782.6

刘艺萍, 孙晓琳, 倪世磊, 赵聪, 葛悦, 周延民, 李明贺. 伴关节盘穿孔的颞下颌关节滑膜软骨瘤1例报告及文献复习[J]. 吉林大学学报(医学版), 2020, 46(03): 639-642.

LIU Yiping, SUN Xiaolin, NI Shilei, ZHAO Cong, GE Yue, ZHOU Yanmin, LI Minghe. Synovial chondromatosis of temporomandibular joint with disc perforation: A case report and literature review[J]. Journal of Jilin University(Medicine Edition), 2020, 46(03): 639-642.

参考文献

[1] REED L S,FOSTER M D,HUDSON J W. Synovial chondromatosis of the temporomandibular joint:A case report and literature review[J]. Cranio,2013,31(4):309-313.
[2] YU Q,YANG J,WANG PZ, et al. CT features of synovial chondromatosis in the temporomandibular joint[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2004,97(4):524-528.
[3] WANG P,TIAN Z,YANG J, et al. Synovial chondromatosis of the temporomandibular joint:MRI findings with pathological comparison[J]. Dentomaxillofac Radiol,2012,41(2):110-116.
[4] HAN Z X, CHEN M J,YANG C, et al. Recurrent synovial chondromatosis of the temporomandibular joint:report of two cases[J]. Br J Oral Maxillofac Surg,2017,55(9):965-967.
[5] BENSLAMA L,SCHOUMAN T,TOURE S,et al. Synovial chondromatosis of the temporomandibular joint:Report and analysis of 12 cases[J].J Stomatol Oral Maxillofac Surg, 2019. 120(5):476-479.
[6] SEMBRONIO S,ALBIERO A M,TORO C, et al. Arthroscopy with open surgery for treatment of synovial chondromatosis of the temporomandibular joint[J]. Br J Oral Maxillofac Surg,2008,46(7):582-584.
[7] BALASUNDARAM A,GEIST J R,GORDON S C, et al. Radiographic diagnosis of synovial chondromatosis of the temporomandibular joint:A case report[J]. J Can Dent Assoc,2009,75(10):711-714.
[8] LIEGER O,ZIX J,STAUFFER-BRAUCH E J, et al. Synovial chondromatosis of the temporomandibular joint with cranial extension:a case report and literature review[J]. J Oral Maxillofac Surg,2007,65(10):2073-2080.
[9] LIU X G,HUANG Z Y,ZHU W Y, et al. Clinical and imaging findings of temporomandibular joint synovial chondromatosis:an analysis of 10 cases and literature review[J]. J Oral Maxillofac Surg,2016,74(11):2159-2168.
[10] GUARDA-NARDINI L,PICCOTTI F,FERRONATO G, et al. Synovial chondromatosis of the temporomandibular joint:a case description with systematic literature review[J]. Int J Oral Maxillofac Surg,2010,39(8):745-755.
[11] MCCAFFERY C,DODD M, BEKIROGLU F, et al. Synovial chondromatosis of the temporomandibular joint with extension into the middle cranial fossa and internal carotid canal[J]. Int J Oral Maxillofac Surg,2017,46(7):867-870.
[12] YOSHITAKE H,KAYAMORI K,WAKE S, et al. Synovial chondromatosis of the right side temporomandibular joint extending to the middle cranial fossa:a case report with 7-year postoperative follow up and expression of a biomarker of cell proliferative activity[J]. Int J Surg Case Rep,2016,20:133-137.
[13] ROMANO A,FARO C L,SALZANO G, et al. Synovial chondromatosis of temporomandibular joint spreading into the cranial space[J]. J Oral Maxillofac Surg Med Pathol,2018,30(3):267-271.
[14] JEYARAJ P E,SHARMA V. Synovial osteochondromatosis of the temporomandibular joint manifesting as a large infratemporal space occupying lesion[J]. J Oral Maxillofac Surg,2017,16(3):387-391.
[15] WILMS C T,HEIM N,TESCHKE M, et al. Synovial chondromatosis of the temporomandibular joint:Immunohistochemical examinations regarding the role of insulin-like growth factors and their binding proteins in the etiology of this disease[J]. J Craniomaxillofac Surg,2017,45(2):198-202.
[16] LI Y,EL MOZEN L A,CAI H, et al. Transforming growth factor beta 3 involved in the pathogenesis of synovial chondromatosis of temporomandibular joint[J]. Sci Rep, 2015,5:8843.
[17] WAKE S,YOSHITAKE H,KAYAMORI K, et al. Expression of CD90 decreases withprogression of synovial chondromatosis in the temporomandibular joint[J]. Cranio,2016,34(4):250-256.
[18] MILGRAMJ W. The classification of loose bodies in human joints[J]. Clin Orthop Relat Res, 1977(124):282-291.
[19] 李颖杰,冯亚平,邓末宏, 等. 颞下颌关节滑膜软骨瘤病的病理特征[J]. 口腔医学研究,2017,33(11):1135-1138.
[20] LEITE P C C,TOLENTINO E S,YAMASHITA A L, et al. Surgical treatment of synovial chondromatosis in the inferior compartment of the temporomandibular joint with articular disc involvement[J]. J Craniofac Surg,2018,29(2):e199-e203.
[21] NOYEK A M,HOLGATE R C,FIREMAN S M,et al. The radiologic findings in synovial chondromatosis (chondrometaplasia) of the temporomandibular joint[J]. J Otolaryngol,1977,6(3 suppl):45-48.
[22] 韩孜祥,陈敏洁,杨驰,等. 171例颞下颌关节滑膜软骨瘤病MRI分析[J]. 中国口腔颌面外科杂志,2017,15(1):41-45.
[23] LIU X,WAN S,SHEN P, et al. Diagnostic accuracy of synovial chondromatosis of the temporomandibular joint on magnetic resonance imaging[J]. PLoS One,2019,14(1):e0209739.
[24] SINK J,BELL B,MESA H. Synovial chondromatosis of the temporomandibular joint:clinical, cytologic, histologic, radiologic, therapeutic aspects, and differential diagnosis of an uncommon lesion[J]. Oral Surg Oral Med Oral Pathol Oral Radiol,2014, 117(3):e269-e274.
[25] BAI G,YANG C,QIU Y, et al. Open surgery assisted with arthroscopy to treat synovial chondromatosis of the temporomandibular joint[J]. Int J Oral Maxillofac Surg,2017,46(2):208-213.

伴关节盘穿孔的颞下颌关节滑膜软骨瘤1例报告及文献复习

Synovial chondromatosis of temporomandibular joint with disc perforation: A case report and literature review

RichHTML

PDF (PC)

赞

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 3

Metrics

本文评价

推荐阅读 0

[1]	白芃, 于镇滔, 孙嘉良, 程凯亮, 韩莹莹, 李幼琼. 采用CT三维图像测量国人颞下颌关节假体固定区域形态学参数及其临床意义[J]. 吉林大学学报(医学版), 2017, 43(05): 985-989.
[2]	韩明林, 李明贺, 及昕, 韩茹钰, 张宁, 崔磊华, 孙兰芳, 韩成敏. 兔颞下颌关节突缺损模型的建立和CFR-PEEK材料人造关节的修复效果评价[J]. 吉林大学学报(医学版), 2017, 43(05): 903-909.
[3]	刘建华\|张文涛\|包霆威\|丁鑫\|李志勇. 颞下颌关节滑膜软骨瘤病诊治的研究进展[J]. J4, 2012, 38(4): 817-820.