Management of tenosynovial giant cell tumour of the temporomandibular joint: a systematic review

Abstract

Diffuse type tenosynovial giant cell tumour of the temporomandibular joint (D-TGCT-TMJ) is a rare proliferative disorder. The aim of this study was to perform a systematic review of the literature to summarize D-TGCT-TMJ management regimes and recurrence rates with at least 12 months of follow-up. Our secondary aim was to propose a minimum period of post-operative follow-up. A medline search for any D-TGCT-TMJ case detailing treatment, follow-up of at least 12 months, and presence of recurrence was undertaken. The following variables were extracted from the studies: patient's age and sex, presence of middle cranial fossa invasion, treatment undertaken, total length of follow-up, and presence of recurrence. All studies were assessed for bias as per the Joanna Briggs Institute systematic reviews appraisal tool. There were 63 cases reviewed and were predominantly managed with total resection (60.3%). Other modalities included: arthroplasty, subtotal resection with or without postoperative radiotherapy, medical therapy and surveillance. The recurrence rate was 9.52% and the longest follow-up period where recurrence was observed was at 60 months. Total resection and arthroplasty are common D-TGCT-TMJ management regimes. Patients with D-TGCT-TMJ should be followed up annually for at least 5 years postoperatively to assess for recurrence.

Clinical retrospective analysis with a predictive model for diffused-tenosynovial giant cell tumors of the temporomandibular joint

“…Previous studies reported that about 30%~50% of cases had skull base invasion. The 68.6% rate of middle cranial fossa invasion in my cohort closely matches the 66% rate found in the systematic review by Kanbour et al This aligns with their large case series and confirms the high propensity for intracranial extension in TMJ D-TSGCT [ 21 ]. The skull base (48/70) and condyle (31/70) were the most affected bone in the TMJ area.…”

“…Retrospective investigation of TMJ D-TSGCT patients by Carlson revealed an 11% local recurrence incidence in surgically treated patients [ 29 ]. Our recurrence rate was 9.5%, identical to the 9.52% recurrence rate in the 63 reported TMJ D-TSGCT reviewed cases [ 21 ]. In our earlier investigation, the average time for D-TSGCT in TMJ to recur in published references was roughly 6 years following the intervention [ 20 ].…”