Imaging features of chondrosarcoma of the temporomandibular joint: report of nine cases and literature review

Jang, B.G.; Huh, Kyung-Hoe; Kang, Jeong‐Hyun; Kim, J.E.; Yi, Won-Jin; Heo, Min-Suk; Lee, S.S.

doi:10.1016/j.crad.2020.07.016

Cited by 5 publications

(4 citation statements)

References 41 publications

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“…In our cases and the cases from the literature, CT and MRI demonstrated bony destruction and tumor spread, which aided in the differential diagnosis and enabled creation of an adequate treatment plan [ 24 , 45 ]. Image findings such as outward growth from the condyle, various patterns of internal enhancement, and markedly hyperintense T2 signal areas were noted [ 12 ]. In our cases, an active lesion in the TMJ with no metastatic bone lesion was observed on PET-CT.…”

Section: Discussionmentioning

confidence: 99%

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Surgical management and final outcomes of chondrosarcoma of the temporomandibular joint: case series and comprehensive literature review

Oh,

Yoon,

Huh

et al. 2023

World J Surg Onc

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Background Surgical management for chondrosarcoma of the temporomandibular joint (TMJ) is challenging due to the anatomical location involving the facial nerve and the functional joint. The purpose of this case series was to analyze the largest number of TMJ chondrosarcoma cases reported from a single institution and to review the literature about chondrosarcoma involving the TMJ. Methods Ten TMJ chondrosarcoma patients at Seoul National University Dental Hospital were included in this study. Radiographic features, surgical approaches, histopathologic subtypes, and treatment modalities were evaluated. All case reports of TMJ chondrosarcoma published in English from 1954 to 2021 were collected under PRISMA guidelines and comprehensively reviewed. Results The lesions were surgically resected in all 10 patients with efforts to preserve facial nerve function. Wide excision including margins of normal tissue was performed to ensure adequate resection margins. All TMJs were reconstructed with a metal condyle except one, which was reconstructed with vascularized costal bone. At last follow-up, all patients were still alive, and there had been no recurrence. Among 47 cases (patients from the literature and our cases), recurrence was specified in 43 and occurred in four (9.5%). Conclusions For surgical management of TMJ chondrosarcoma, wide excision must consider preservation of the facial nerve. Reconstruction using a metal condyle prosthesis and a vascularized free flap is reliable. A more conservative surgical approach correlates with a favorable prognosis for facial nerve recovery. Nevertheless, wide excision is imperative to prevent tumor recurrence. In cases in which the glenoid fossa is unaffected by the tumor, it is deemed unnecessary to reconstruct the glenoid fossa within an oncological setting.

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Section: Discussionmentioning

confidence: 99%

“…In this study, MRI, contrast-enhanced computed tomography (CT), and positron emission tomography-CT (PET-CT) were performed for radiographic examination [ 12 ]. Open biopsy was conducted for pathologic confirmation of the diagnosis.…”

Section: Methodsmentioning

confidence: 99%

Surgical management and final outcomes of chondrosarcoma of the temporomandibular joint: case series and comprehensive literature review

Oh,

Yoon,

Huh

et al. 2023

World J Surg Onc

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“…On conventional X-ray and CT, puncture, annular, semiannular, or gravel calcification were seen in the solid portion of the chondrosarcoma, and scallop-like changes were seen in the adjacent cortical bone (8). Due to its high soft tissue resolution, MRI has been widely used in the diagnosis and differential diagnosis of chondrosarcoma, especially for the morphological characteristics of the tumor, such as marrow edema, soft tissue mass, periosteal reaction, etc.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a MRI-based combined radiomics nomogram for differentiation in chondrosarcoma

Lan²,

Wang³

et al. 2023

Front. Oncol.

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ObjectiveThis study aims to develop and validate the performance of an unenhanced magnetic resonance imaging (MRI)-based combined radiomics nomogram for discrimination between low-grade and high-grade in chondrosarcoma.MethodsA total of 102 patients with 44 in low-grade and 58 in high-grade chondrosarcoma were enrolled and divided into training set (n=72) and validation set (n=30) with a 7:3 ratio in this retrospective study. The demographics and unenhanced MRI imaging characteristics of the patients were evaluated to develop a clinic-radiological factors model. Radiomics features were extracted from T1-weighted (T1WI) images to construct radiomics signature and calculate radiomics score (Rad-score). According to multivariate logistic regression analysis, a combined radiomics nomogram based on MRI was constructed by integrating radiomics signature and independent clinic-radiological features. The performance of the combined radiomics nomogram was evaluated in terms of calibration, discrimination, and clinical usefulness.ResultsUsing multivariate logistic regression analysis, only one clinic-radiological feature (marrow edema OR=0.29, 95% CI=0.11-0.76, P=0.012) was found to be independent predictors of differentiation in chondrosarcoma. Combined with the above clinic-radiological predictor and the radiomics signature constructed by LASSO [least absolute shrinkage and selection operator], a combined radiomics nomogram based on MRI was constructed, and its predictive performance was better than that of clinic-radiological factors model and radiomics signature, with the AUC [area under the curve] of the training set and the validation set were 0.78 (95%CI =0.67-0.89) and 0.77 (95%CI =0.59-0.94), respectively. DCA [decision curve analysis] showed that combined radiomics nomogram has potential clinical application value.ConclusionThe MRI-based combined radiomics nomogram is a noninvasive preoperative prediction tool that combines clinic-radiological feature and radiomics signature and shows good predictive effect in distinguishing low-grade and high-grade bone chondrosarcoma, which may help clinicians to make accurate treatment plans.

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“…10e12 Clinicians, radiologists, and pathologists experience difficulty in the differentiation of SC from other pathologies, such as parotid cancer, 13,14 pseudogout, 15 osteoarthrosis, 16,17 TMJ disorders, 18 and chondrosarcoma. 19,20 In particular, it may be more difficult to differentiate SC from malignant cartilage neoplasms histopathologically, 19 such as grade I or II chondrosarcoma, because these tumours share some histopathological features, including nuclear crowding and enlargement. 11,21 Thus, achieving accurate differentiation between SC and chondrosarcoma using available imaging techniques is crucial; however, the imaging features of SC of the TMJ have been described inconsistently, with only small case reports published and, often, only the computed tomography (CT) image findings disclosed.…”

Section: Introductionmentioning

confidence: 99%

Imaging features of synovial chondromatosis of the temporomandibular joint: a report of 34 cases

et al. 2021

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To investigate the imaging features of synovial chondromatosis of the temporomandibular joint (TMJ), which is a rare benign arthropathy with cartilaginous proliferation.MATERIALS AND METHODS: Computed tomography and magnetic resonance imaging examinations of 34 patients with histopathologically confirmed primary synovial chondromatosis of the TMJ were reviewed retrospectively. Imaging features including the lesion epicentre, destruction/sclerosis of surrounding bone, calcification, periosteal reaction, osteophyte, lesion size, and joint space dimensions were assessed.RESULTS: Thirty-one of thirty-four patients (91.2%) showed the superior joint space as the lesion epicentre. For the mandibular condyle, more than one-third of patients (14/34; 41.2%) showed no destruction, and more than half of patients (19/34; 55.9%) showed no sclerosis. Conversely, >70% of patients showed destruction and sclerosis of the articular eminence/ glenoid fossa, while >80% of patients (28/34; 82.4%) presented with various calcifications, including the ring-and-arc (9/34; 26.5%) and popcorn (13/34; 38.2%) types. The mean joint space on the affected side was significantly larger than that of the unaffected side (p<0.001). More than three-fourths of patients (76.9%) experienced no interval increase in lesion size during an average of 1.6 years of follow-up.CONCLUSION: Synovial chondromatosis of the TMJ demonstrated several imaging features, including the lesion centre being located in the superior joint space, resultant articular eminence/glenoid fossa-oriented bone changes, ring-and-arc and popcorn calcification, joint space widening, and self-limiting growth. These imaging features may be helpful in differentiating synovial chondromatosis from other lesions of the TMJ.

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Imaging features of chondrosarcoma of the temporomandibular joint: report of nine cases and literature review

Cited by 5 publications

References 41 publications

Surgical management and final outcomes of chondrosarcoma of the temporomandibular joint: case series and comprehensive literature review

Surgical management and final outcomes of chondrosarcoma of the temporomandibular joint: case series and comprehensive literature review

Development and validation of a MRI-based combined radiomics nomogram for differentiation in chondrosarcoma

Imaging features of synovial chondromatosis of the temporomandibular joint: a report of 34 cases

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