Pigmented villonodular synovitis of the temporomandibular joint: Case report and review of the literature.

Abstract

We present a case of a 51-year-old male patient with pigmented villonodular synovitis (PVNS) of the left temporomandibular joint (TMJ) that initially presented as a slow-growing left facial mass. Upon further workup, a contrast-enhanced CT scan demonstrated an expansile soft tissue mass in the left TMJ. The lesion was diagnosed through fine-needle aspiration biopsy. The patient was treated with resection of the TMJ, temporal bone, and root of the zygoma. A temporalis muscle and temporoparietal fascia flap was used for reconstruction to fill the defect and provide contour. Postoperatively, the patient has been tumor free with excellent cosmesis. Our case demonstrates a very successful outcome. Previous literature has also reported that complete excision is an ideal procedure for PVNS of TMJ, but temporalis rotational flap use has been rare. This case and previously reported cases in the literature are also reviewed.