Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 16, 2021; 9(11): 2662-2670
Published online Apr 16, 2021. doi: 10.12998/wjcc.v9.i11.2662
Calcium pyrophosphate deposition disease of the temporomandibular joint invading the middle cranial fossa: Two case reports
Ting Tang, Fu-Gang Han
Ting Tang, Fu-Gang Han, Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan Province, China
Author contributions: Tang T consulted the literature, collected clinical data and images and wrote the paper; Han FG designed the research, reviewed and revised the paper.
Informed consent statement: Informed written consent was obtained from the patients.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fu-Gang Han, MD, Doctor, Full Professor, Department of Radiology, The Affiliated Hospital of Southwest Medical University, Third Section of Zhongshan Road, Jiangyang District, Luzhou 646000, Sichuan Province, China. 8311hfg@163.com
Received: December 14, 2020
Peer-review started: December 14, 2020
First decision: December 28, 2020
Revised: January 3, 2021
Accepted: February 9, 2021
Article in press: February 9, 2021
Published online: April 16, 2021
Processing time: 108 Days and 4 Hours
Abstract
BACKGROUND

Pseudogout is a benign joint lesion caused by the deposition of calcium pyro-phosphate dihydrate crystals, but it is invasive. Pseudogout of the temporo-mandibular joint (TMJ) is uncommon, and it rarely invades the skull base or penetrates into the middle cranial fossa. The disease has no characteristic clinical manifestations and is easily misdiagnosed.

CASE SUMMARY

We present two cases of tophaceous pseudogout of the TMJ invading the middle cranial fossa. A 46-year-old woman with a history of diabetes for more than 10 years was admitted to the hospital due to swelling and pain in the right temporal region. Another patient, a 52-year-old man with a mass in the left TMJ for 6 years, was admitted to the hospital. Maxillofacial imaging showed a calcified mass and severe bone destruction of the skull base in the TMJ area. Both patients underwent excision of the lesion. The lesion was pathologically diagnosed as tophaceous pseudogout. The symptoms in these patients were relieved after surgery.

CONCLUSION

Tophaceous pseudogout should be considered when there is a calcified mass in the TMJ with or without bone destruction. A pathological examination is the gold standard for diagnosing this disease. Surgical treatment is currently the recommended treatment, and the prognosis is good after surgery.

Keywords: Tophaceous pseudogout; Temporomandibular joint; Middle cranial fossa; Calcium pyrophosphate deposition disease; Case report

Core Tip: Tophaceous pseudogout is a benign lesion caused by calcium pyrophosphate dihydrate crystal deposition and uncommonly involves the temporomandibular joint. We report two cases of pseudogout in the temporomandibular joint invading the middle cranial fossa, which is rare. Surgical treatment is recommended for this disease, and the prognosis is good. A pathological examination is the gold standard for the diagnosis of pseudogout. Large rod or rhombus crystal deposits within the mass are pathological features of tophaceous pseudogout.