Robert B. MacIntosh, DDS, Faisal Khan, DDS, MD, Bret M. Waligora, BS

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Presentation transcript:

Chondrosarcoma of the Temporomandibular Disc: Behavior Over a 28-Year Observation Period Robert B. MacIntosh, DDS, Faisal Khan, DDS, MD, Bret M. Waligora, BS Journal of Oral and Maxillofacial Surgery Volume 73, Issue 3, Pages 465-474 (March 2015) DOI: 10.1016/j.joms.2014.09.020 Copyright © 2015 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 1 Maximum comfortable vertical mouth opening at initial examination. Journal of Oral and Maxillofacial Surgery 2015 73, 465-474DOI: (10.1016/j.joms.2014.09.020) Copyright © 2015 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 2 Computer tomographic evaluation at initial examination, with arrows indicating the calcifiying soft tissue lesion. Journal of Oral and Maxillofacial Surgery 2015 73, 465-474DOI: (10.1016/j.joms.2014.09.020) Copyright © 2015 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 3 Exposure of tumor showing its continuity with the articular disc (arrow). Journal of Oral and Maxillofacial Surgery 2015 73, 465-474DOI: (10.1016/j.joms.2014.09.020) Copyright © 2015 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 4 Underside of tumor in the disc, illustrating the position of the condylar head. Journal of Oral and Maxillofacial Surgery 2015 73, 465-474DOI: (10.1016/j.joms.2014.09.020) Copyright © 2015 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 5 Histologic appearance of tumor, displaying sheets of neoplastic myxoid and hyalin cartilage, surrounded by fibrous connective tissue; the cells are pleomorphic and disorganized, with multiple and pyknotic nuclei and atypical mitotic figures. A, Lesion abutting normal discal tissue (100× magnification). B, Islands of tumor within adjacent normal periarticular tissues (40× magnification). Histologic stains are hematoxylin and eosin. Journal of Oral and Maxillofacial Surgery 2015 73, 465-474DOI: (10.1016/j.joms.2014.09.020) Copyright © 2015 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 6 Depth of wound into infratemporal fossa after excision of residual tumor at the second operation. The condyle has been temporarily resected for exposure, and the dermal graft placed 8 days previously is evident. Journal of Oral and Maxillofacial Surgery 2015 73, 465-474DOI: (10.1016/j.joms.2014.09.020) Copyright © 2015 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 7 Disclosure of nodular residual tumor (arrow) in depth of wound after resection of the fibrous ankylotic bloc. Journal of Oral and Maxillofacial Surgery 2015 73, 465-474DOI: (10.1016/j.joms.2014.09.020) Copyright © 2015 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 8 Radiographic status of calcifications (arrows) in later years. A, A 2006 film shows calcifications that were interpreted as being with the lateral pterygoid muscle and stable since 2003. B, A 2009 film shows calcifications that were reported as stable without evidence of soft tissue mass. C, Scan from 2013 was interpreted as showing essentially no change during the previous 10 years. Journal of Oral and Maxillofacial Surgery 2015 73, 465-474DOI: (10.1016/j.joms.2014.09.020) Copyright © 2015 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 8 Radiographic status of calcifications (arrows) in later years. A, A 2006 film shows calcifications that were interpreted as being with the lateral pterygoid muscle and stable since 2003. B, A 2009 film shows calcifications that were reported as stable without evidence of soft tissue mass. C, Scan from 2013 was interpreted as showing essentially no change during the previous 10 years. Journal of Oral and Maxillofacial Surgery 2015 73, 465-474DOI: (10.1016/j.joms.2014.09.020) Copyright © 2015 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 8 Radiographic status of calcifications (arrows) in later years. A, A 2006 film shows calcifications that were interpreted as being with the lateral pterygoid muscle and stable since 2003. B, A 2009 film shows calcifications that were reported as stable without evidence of soft tissue mass. C, Scan from 2013 was interpreted as showing essentially no change during the previous 10 years. Journal of Oral and Maxillofacial Surgery 2015 73, 465-474DOI: (10.1016/j.joms.2014.09.020) Copyright © 2015 American Association of Oral and Maxillofacial Surgeons Terms and Conditions