良性和恶性肿瘤可以像任何其他关节一样影响颞下颌关节(TMJ)。然而,TMJ肿瘤是罕见的,大多数是良性的。它们的临床表现是多种多样的,包括类似于TMJ功能障碍的症状学,耳科或神经病理学。在某些情况下,他们仍然完全无症状。因此,诊断是困难的,因为症状可能误导TMJ功能障碍或耳科疾病的错误诊断。因此,在症状发作和诊断之间经常存在长的延迟。种类繁多的TMJ病变解释了广泛的可能的治疗方式,主要是基于手术。我们在此对源自TMJ的病变进行综述。不讨论通过局部延伸影响TMJ的肿瘤或囊性下颌病变。骨瘤,骨样骨瘤,成骨细胞瘤,软骨瘤,骨软骨瘤,软骨母细胞瘤,腱鞘巨细胞瘤,巨细胞病变,非骨化性纤维瘤,血管瘤,在TMJ中发现的良性肿瘤中,脂肪瘤或朗格汉斯细胞组织细胞增生症都是可能的诊断。假瘤包括滑膜软骨瘤病和动脉瘤样骨囊肿。最后,TMJ的恶性肿瘤主要包括肉瘤(骨肉瘤,软骨肉瘤,滑膜肉瘤,尤因肉瘤,和纤维肉瘤),还有多发性骨髓瘤和继发性转移。我们将回顾临床,这些病变的放射学和组织学方面。还将讨论治疗和复发风险。
Benign and malign tumors can affect the temporomandibular joint (TMJ) as any other articulation. Nevertheless, TMJ tumors are rare and mostly benign. Their clinical expression is varied including symptomatology similar to TMJ dysfunctional disorders, otologic or neurologic pathologies. In some cases, they remain totally asymptomatic. Hence, diagnosis is difficult since the symptomatology can be misleading with TMJ dysfunctional disorders or otologic disorders wrongly diagnosed. There is thus frequently a long delay between symptoms onset and diagnosis. The great variety of TMJ lesions explains the wide range of possible treatment modalities, mostly based on surgery. We provide here a
review of the lesions originating from the TMJ. Tumoral or cystic mandibular lesion affecting the TMJ through local extension will not be discussed. Osteoma, osteoid osteoma, osteoblastoma, chondroma, osteochondroma, chondroblastoma, tenosynovial giant cell tumors, giant cell lesions, non-ossifying fibroma, hemangioma, lipoma or Langerhans cell histiocytosis are all possible diagnosis among the benign tumors found in the TMJ. Pseudotumors include synovial chondromatosis and aneurysmal bone cyst. Finally, malign tumors of the TMJ include mainly sarcomas (osteosarcoma, chondrosarcoma, synovial sarcoma, Ewing sarcoma, and fibrosarcoma), but also multiple myeloma and secondary metastases. We will
review the clinical, radiological and histological aspects of each of these lesions. The treatment and the recurrence risk will also be discussed.