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Chi AC, Schubert E, Naik K, Kaleem A, Lavezo J, Chen E, Liu YJ, Wu Y, Reith JD, Brockhoff HC. Calcified chondroid mesenchymal neoplasm: report of a case involving the temporomandibular joint region and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:e131-e142. [PMID: 38616481 DOI: 10.1016/j.oooo.2023.12.791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/31/2023] [Indexed: 04/16/2024]
Abstract
The calcified chondroid mesenchymal neoplasm (CCMN) represents a recently recognized tumor type with only 50 well-documented cases in the English-language literature. Herein we report an additional case of CCMN presenting as a large mass in the temporomandibular joint region of a 41-year-old female. A review of previously reported cases and the current case of CCMN shows the following features: 1) average age 52 years (range 14-87 years) and an approximately even sex distribution; 2) most frequently involved sites: distal extremities (including foot, hand, wrist, forearm) (n=41) and temporomandibular joint/temporal/parotid region (n=9); 3) multilobular soft tissue tumor with chondroid to cartilaginous matrix, often grungy or lace-like calcifications, and variable cytologic atypia; 4) frequently detected FN1 rearrangement (n=15), including FN1 fusion with FGFR2 (n=7) or other receptor tyrosine kinases; 5) 2 reported local recurrences (after incomplete excision); 6) no reports of malignant biologic behavior.
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Affiliation(s)
- Angela C Chi
- Professor, Woody L. Hunt School of Dental Medicine, Texas Tech University Health Sciences Center, El Paso, TX.
| | - Enrique Schubert
- Oral and Maxillofacial Surgeon, Oral/Head and Neck Oncology and Microvascular Reconstructive Surgery, Private Practice, Mountain State Oral and Facial Surgery, Charleston, WV
| | - Keyur Naik
- Head and Neck and Microvascular Surgery Fellow, High Desert Oral and Facial Surgery, El Paso Children's Hospital, and University Medical Center of El Paso, El Paso, TX
| | - Arshad Kaleem
- Oral and Maxillofacial Surgeon, High Desert Oral and Facial Surgery, El Paso, TX
| | - Jonathan Lavezo
- Assistant Professor, Department of Pathology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX
| | - Eleanor Chen
- Associate Professor of Laboratory Medicine and Pathology, University of Washington Medical Center, Seattle, WA
| | - Yajuan J Liu
- Professor, Department of Laboratory Medicine and Pathology, Program Director, ACGME Laboratory Genetics and Genomics (LGG) Fellowship, Director, Clinical Genomics Laboratory, Director, Cytogenetics Laboratory at UW Medical Center, University of Washington School of Medicine, Seattle, WA
| | - Yu Wu
- Clinical Genomics Laboratory, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA
| | - John D Reith
- Staff Pathologist, Department of Pathology, Cleveland Clinic, Cleveland, OH
| | - Hans C Brockhoff
- Division Chief, Oral/Head and Neck Oncology and Microvascular Reconstructive Surgery, El Paso Children's Hospital/University Medical Center of El Paso, Partner and Oral and Maxillofacial Surgeon, High Desert Oral and Facial Surgery, El Paso, TX
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Bschorer F, Höller S, Baumhoer D, Bschorer R. Pseudogout growing from the temporomandibular joint into the middle cranial fossa. Oral Maxillofac Surg 2024; 28:441-445. [PMID: 36194300 DOI: 10.1007/s10006-022-01117-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/17/2022] [Indexed: 11/25/2022]
Abstract
Calcium pyrophosphate dihydrate deposition disease (CPDD or pseudogout) is a degenerative joint disease. It is defined by the presence of calcium pyrophosphate dihydrate crystals. It usually manifests in the knee and wrist. Manifestation in the temporomandibular joint (TMJ) is only reported in case reports. We present a patient with CPDD mimicking a malignant tumor of the TMJ. A 53-year-old woman presented with progressive pain and a slow-growing swelling of the left TMJ. Imaging showed an extensive mass in the infratemporal fossa extending into the middle cranial fossa and compressing the temporal lobe. Assuming a potential malignancy, we excised the growth, which extended into the dura. We covered the resulting tissue defect within the primary surgery using a microsurgically anastomosed scapular flap and performed further reconstructive surgeries. Calcium pyrophosphate dihydrate crystals were found in the histopathologic examination of the excised tissue, resulting in the diagnosis of CPDD. That is a benign diagnosis, but we treated it like a malignancy. This leads us to the question, was there overtreatment? Tumoral CPDD in the TMJ can be a difficult diagnosis to obtain. The treatment remains controversial, but complete excision of the mass was performed in most reported cases.
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Affiliation(s)
- Frizzi Bschorer
- Department of Oral and Maxillofacial Surgery, Helios Kliniken Schwerin, Wismarsche Straße 393-397, 19049, Schwerin, Germany.
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, University Medical Center Rostock, Schillingallee 35, 18057, Rostock, Germany.
| | - Sylvia Höller
- Institute of Pathology, University Hospital Basel, Schönbeinstrasse 40, 4031, Basel, CH, Switzerland
- Institute of Pathology, University Hospital Zürich, Schmelzbergstrasse 12, 8091, Zurich, CH, Switzerland
| | - Daniel Baumhoer
- Institute of Pathology, University Hospital Basel, Schönbeinstrasse 40, 4031, Basel, CH, Switzerland
| | - Reinhard Bschorer
- Department of Oral and Maxillofacial Surgery, Helios Kliniken Schwerin, Wismarsche Straße 393-397, 19049, Schwerin, Germany
- MKG-Praxis Am Stadthafen, Schliemannstr. 18, 19055, Schwerin, Germany
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