Treatments of tenosynovial giant cell tumours of the temperomandibular joint: a report of three cases and a review of literature
until further notice
SourceInternational Journal of Oral and Maxillofacial Surgery, 47, 10, (2018), pp. 1288-1294
Article / Letter to editor
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Oral and Maxillofacial Surgery
International Journal of Oral and Maxillofacial Surgery
SubjectRadboudumc 0: Other Research RIHS: Radboud Institute for Health Sciences; Radboudumc 10: Reconstructive and regenerative medicine RIHS: Radboud Institute for Health Sciences; Radboudumc 9: Rare cancers RIHS: Radboud Institute for Health Sciences; Radboudumc 9: Rare cancers RIMLS: Radboud Institute for Molecular Life Sciences
Tenosynovial giant cell tumours (TGCTs) are benign lesions affecting synovial joints. The classified subtypes are localized and diffuse. They seldom occur in the temporomandibular joint (TMJ). The aim of this study is to report on three new cases and to review the literature. One patient had surgical debulking with adjuvant external beam radiation therapy (EBRT). After 1year of follow-up, no evidence of disease was presented. The second patient was misdiagnosed and treated with denosumab. Debulking with adjuvant EBRT followed. Ten months postoperatively, no disease progression was seen. The third patient received systemic nilotinib and remained stable for over 5years. The literature review included 106 cases of which 95 had diffuse subtype. Most patients, had surgical excision. Thirteen (14%) patients received adjuvant EBRT. Eleven (14%) recurrences were identified. After 1-, 5- and 10 years of follow-up, an overall progression-free survival (PFS) of 99% (95% confidence interval (CI) 0.96-1), 80% (95% CI 0.68-0.94), 67% (95% CI 0.51-0.90) was calculated, respectively. Treatments for diffuse-TGCT-TMJ should be individualized depending on age, severity of symptoms, extent of disease and progression, expected mutilation of surgical interference, and current systemic treatment options. In stable disease a 'wait and see' policy, is a viable option. Additional treatments should be reserved for symptomatic, irresectable tumours or residual disease after surgical treatment with persistent complaints.
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