顎関節に発生した結節性偽痛風の1例 A case of tophaceous pseudogout arising in the temporomandibular joint
We report an unusual case of tophaceous pseudogout (tumoral calcium pyrophosphate dihydrate crystal deposition disease: CPPD) involving the temporomandibular joint (TMJ).<BR>A 76-year-old woman was referred to our hospital because of a tumor-like lesion around the right TMJ on a computed tomographic (CT) scan, taken at the department of neurosurgery to evaluate a head bruise. The patient had had right TMJ clicking sounds without pain for the past 20 years. Recently, she noticed swelling of the right cheek. Because the swelling was painless, the patient received no treatment. The medical history and results of clinical examinations were unremarkable. A CT scan revealed a heterogeneous mass with well circumscribed borders around the right condyle. There was moderately limited translation of the right condyle and slight deviation of the mandible to the right side in open position. The lesion was removed under general anesthesia. The lesion measured more than 4 cm in greatest dimension and had a white chalky appearance. Microscopically, the most distinctive feature was the presence of islands of crystalline material in which individual crystals showed a needlelike configuration. On the basis of these findings, tophaceous pseudogout was diagnosed. There has been no sign of recurrence for 16 months after operation.
日本口腔外科学会雑誌 52(6), 358-361, 2006-06-20
Japanese Society of Oral and Maxillofacial Surgeons