Rafik A Abdelsayed1, Nasser Said-Al-Naief2, Martin Salguerio3, Jon Holmes4, Samir K El-Mofty5. 1. Professor and Director of Diagnostic Laboratory Services, Section of Oral and Maxillofacial Pathology, Department of Oral Health and Diagnostic Sciences, College of Dental Medicine, Georgia Regents University, Augusta, GA, USA. Electronic address: rabdelsa@gru.edu. 2. Professor, Oral Diagnosis, Radiology and Pathology, Loma Linda University, SOD and School of Medicine, Department of Anatomy and Pathology/Head and Neck Pathology, San Francisco, CA, USA. 3. Assistant Professor, Department of Oral and Maxillofacial Surgery, College of Dental Medicine, Georgia Regents University, Augusta, GA, USA. 4. Private Oral and Maxillofacial Surgery, Birmingham, AL, USA. 5. Head, Section of Head and Neck Pathology, Professor, Division of Anatomic and Molecular Pathology, Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO, USA.
Abstract
OBJECTIVE: We report a series of 3 cases of tophaceous pseudogout of the temporomandibular joint (TMJ). STUDY DESIGN: Three patients, two men and one woman, ranging in age between 60 and 75 years, presented with unilateral painful swelling of the TMJ area associated with limitation of mouth opening. RESULTS: Radiographic and computed tomographic images showed opaque masses in the supracondylar region of the TMJ. The preoperative clinical impression was a "neoplastic lesion" in the 3 cases. Microscopic examination revealed numerous deeply basophilic masses of calcified deposits, exhibiting birefringence under polarized light and morphologically consistent with calcium pyrophosphate dihydrate deposition, referred to in these cases as "tophaceous pseudogout." CONCLUSION: Tophaceous pseudogout is a rare benign arthropathy that presents with clinical and radiographic features mimicking neoplastic conditions of the TMJ. Therefore, it is recommended that tophaceous pseudogout be considered in the differential diagnosis when a TMJ is involved with "neoplasm-like" lesions clinically and radiographically. Published by Mosby, Inc.
OBJECTIVE: We report a series of 3 cases of tophaceous pseudogout of the temporomandibular joint (TMJ). STUDY DESIGN: Three patients, two men and one woman, ranging in age between 60 and 75 years, presented with unilateral painful swelling of the TMJ area associated with limitation of mouth opening. RESULTS: Radiographic and computed tomographic images showed opaque masses in the supracondylar region of the TMJ. The preoperative clinical impression was a "neoplastic lesion" in the 3 cases. Microscopic examination revealed numerous deeply basophilic masses of calcified deposits, exhibiting birefringence under polarized light and morphologically consistent with calcium pyrophosphate dihydrate deposition, referred to in these cases as "tophaceous pseudogout." CONCLUSION: Tophaceous pseudogout is a rare benign arthropathy that presents with clinical and radiographic features mimicking neoplastic conditions of the TMJ. Therefore, it is recommended that tophaceous pseudogout be considered in the differential diagnosis when a TMJ is involved with "neoplasm-like" lesions clinically and radiographically. Published by Mosby, Inc.