Synovial Chondromatosis of the Temporomandibular Joint Successfully Treated by Surgery

Abstract

Synovial chondromatosis (SC) is a chronic process, defined as a reactive cartilaginous proliferation, characterized by formation of cartilaginous nodules, usually loose in the joint space of the synovial membrane. It mainly affects large joints such as knee, hip, shoulder, and elbow, commonly in male patients. However, its manifestation in the Temporomandibular joint (TMJ), is a rare finding, occurring predominantly in females. This paper reports a case of a woman who presented to the service of Stomatology complaining of mouth opening limitations and pain in her left pre-auricular region. After clinical and radiographic analyses, the condition was diagnosed as SC of the TMJ. The loose bodies within the TMJ were removed under general anesthesia. Histological and followup features of this lesion are also discussed. To our knowledge, this is the second report of SC of the TMJ in Brazil.

Surgical treatment of a rare bilateral synovial chondromatosis

“…The increased presence of growth factors such as fibroblast growth factor 2, 3, and 9; and receptors 3 and 1 have been mentioned in previous studies, 5 which seem to promote the lesion growth. Moreover, bone morphogenetic proteins 2 and 4 were shown in cartilaginous nodules suggesting that bone morphogenetic proteins synthetized by the synovia and by the loose bodies promote bone and cartilaginous metaplasia.…”

“…This contributes to the pathogenesis of SC. 3,5 Similar to chondrosarcoma and chondroma of soft tissues, SC belongs to the group of extra-skeletal chondrogenic neoplasms. 1,3 Hyaline cartilage is absent on the joint surface of the normal TMJ.…”

“…2020 Oct-Dec;10(4):e2020183 applied approach . 1,3 Although some authors advocate the use of arthroscopy, 3,5 arguing that it is less invasive, there is a possible limitation of trans-surgical visualization and incomplete removal of cartilaginous bodies. 1 Direct surgical access allows better visualization for excision and less possibility of relapse.…”

“…[1][2][3] Diagnostic imaging methods such as computed tomography and magnetic resonance imaging are important for diagnosis. [1][2][3][4][5][6][7] However, definitive diagnosis is made through clinical correlation with imaging and histopathological examination. 1,7 Due to the paucity of bilateral cases reported in the literature, we report a rare case of bilateral SC with 13 months of follow-up after treatment and a literature discussion.…”

Benign Tumors of Temporomandibular Joint

“…Differential diagnosis should be done with internal derangements, osteoarthritis, osteochondromas, villonodular synovitis, chondroblastoma and focal osteochondritis [37].…”