Intraosseous Lesion in Mandibular Condyle Mimicking Temporomandibular Disorders: Report of 3 Cases

Pain and dysfunction in the temporomandibular joint (TMJ) region represent a diagnostic challenge. Temporomandibular disorders (TMD) are usually diagnosed by means of a thorough patient history and comprehensive clinical examination. However, additional diagnostic tests, such as imaging of the TMJ area, are necessary in cases where the signs do not explain the symptoms. Neoplasms and pseudotumors of the TMJ are quite uncommon, but their early recognition is necessary in order prevent the delay of correct treatment. This report describes 3 cases of different intraosseous lesions of the mandibular condyle in which the patient was erroneously first treated for a TMD.

cyst; differential diagnosis; mandibular condyle; neoplasm; temporomandibular disorders; temporomandibular joint

1. Okeson JO. Differential diagnosis and management considerations of temporomandibular disorders. In: Okeson JP (ed). American Academy of Orofacial Pain. Orofacial Pain: Guidelines for Assessment, Diagnosis, and Management. Chicago: Quintessence, 1996:113–158.

2. Bavitz JB, Chewning LC. Malignant disease as temporomandibular joint dysfunction: Review of the literature and report of case. J Am Dent Assoc 1990;120:163–166.

3. Warner BF, Luna MA, Robert Newland T. Temporomandibular joint neoplasms and pseudotumors. Adv Anat Pathol 2000;7:365–381.

4. Cimino R, Steenks MH, Michelotti A, Farella M, Pier Francesco N. Mandibular condyle osteochondroma. Review of the literature and report of a misdiagnosed case. J Orofac Pain 2003;17:254–261.

5. Hudson JW, Livesay KW, McCoy JM. Condylar lesion. J Oral Maxillofac Surg 2003;61:824–826.

6. Peeples G, Sanders B. Mandibular ramal odontogenic keratocysts involving the coronoid and condyle. J Oral Med 1979;34:90–91.

7. Tanaka H, Westesson PL, Emmings FG, Marashi AH. Simple bone cyst of the mandibular condyle: Report of a case. J Oral Maxillofac Surg 1996;54:1454–1458.

8. Hansen LS, Sapone J, Sproat RC. Traumatic bone cysts of jaws. Oral Surg Oral Med Oral Pathol 1974;37:899–910.

9. Shigematsu H, Fujita K, Watanabe K. Atypical simple bone cyst of the mandible. A case report. Int J Oral Maxillofac Surg 1994;23:298–299.

10. Kuttenberger JJ, Farmand M, Stoss H. Recurrence of a solitary bone cyst of the mandibular condyle in a bone graft. A case report. Oral Surg Oral Med Oral Pathol 1992;74:550–556.

11. Telfer MR, Jones GM, Pell GM, Eveson JW. Primary bone cyst of the mandibular condyle. Br J Oral Maxillofac Surg 1990;28:340–343.

12. Rubin MM, Murphy FJ. Simple bone cyst of the mandibular condyle. J Oral Maxillofac Surg 1989;47:1096–1098.

13. Persson G. An atypical solitary bone cyst. J Oral Maxillofac Surg 1985;43:905–907.

14. Yoon OK, Beag SL, Choi JH, Lee GD. A case report of a traumatic bone cyst occurring in the condylar head of the mandible [in Korean]. Taehan Chikkwa Uisa Hyophoe Chi 1984;22:333–338.

15. Gilman RH, Dingman RO. A solitary bone cyst of the mandibular condyle. Plast Reconstr Surg 1982;70: 610–614.

16. Hosseini M. Two atypical solitary bone cysts. Br J Oral Surg 1979;16:262–269.

17. Abu-El-Naaj I, Ardekian L, Liberman R, Peled M. Central giant cell granuloma of the mandibular condyle: A rare presentation. J Oral Maxillofac Surg 2002;60:939–941.

18. Cohen MA, Hertzanu Y. Radiologic features, including those seen with computed tomography, of central giant cell granuloma of the jaws. Oral Surg Oral Med Oral Pathol 1988;65:255–261.

19. Shensa DR, Nasseri S. Central giant cell reparative granuloma of the mandibular condyle. J Oral Surg 1978;36: 642–643.

20. Tasanen A, von Konow L, Nordling. Central giant-cell lesion in the mandibular condyle. Report of a case. Oral Surg Oral Med Oral Pathol 1978;45:532–539.

21. Chuong R, Kaban LB, Kozakewich H, Perez-Atayde A. Central giant cell lesions of the jaws: A clinicopathologic study. J Oral Maxillofac Surg 1986;44:708–713.

22. Vergel De Dios AM, Bond JR, Shives TC, McLeod RA, Unni KK. Aneurysmal bone cyst. A clinicopathologic study of 238 cases. Cancer 1992;69:2921–2931.

23. Shafer WG, Hine MK, Levy BM. A Textbook of Oral Pathology. Philadelphia: Saunders, 1983:149–152.

24. Struthers PJ, Shear M. Aneurysmal bone cyst of the jaws.(II). Pathogenesis. Int J Oral Surg 1984;13:92–100.

25. Rapidis AD, Vallianatou D, Apostolidis C, Lagogiannis G. Large lytic lesion of the ascending ramus, the condyle, and the infratemporal region. J Oral Maxillofac Surg 2004; 62:996–1001.

26. Motamedi MH. Destructive aneurysmal bone cyst of the mandibular condyle: Report of a case and review of the literature. J Oral Maxillofac Surg 2002;60:1357–1361.

27. Gadre KS, Zubairy RA. Aneurysmal bone cyst of the mandibular condyle: Report of a case. J Oral Maxillofac Surg 2000;58:439–443.

28. Semkin VA, Rabukhina NA, Liashev IN, Seniuk AN. A rare case of an aneurysmal cyst of the mandibular condyle [in Russian]. Stomatologiia (Mosk) 2000;79:47–49.

29. Motamedi MH, Stavropoulos MF. Large radiolucent lesion of the mandibular condyle. J Oral Maxillofac Surg 1997;55:1300–1304.

30. Svensson B, Isacsson G. Benign osteoblastoma associated with an aneurysmal bone cyst of the mandibular ramus and condyle. Oral Surg Oral Med Oral Pathol 1993; 76:433–436.

31. Lichtenstein L. Histiocytosis X; integration of eosinophilic granuloma of bone, Letterer-Siwe disease, and Schüller-Christian disease as related manifestations of a single nosologic entity. AMA Arch Pathol 1953;56:84–102.

32. Wong GB, Pharoah MJ, Weinberg S, Brown DH. Eosinophilic granuloma of the mandibular condyle: Report of three cases and review of the literature. J Oral Maxillofac Surg 1997;55:870–878.

33. Hartman KS. Histiocytosis X: A review of 114 cases with oral involvement. Oral Surg Oral Med Oral Pathol 1980; 49:38–54.

34. Siessegger M, Klesper B, Kasper HU, Zoeller JE. Monolocular Langerhans cell histiocytosis of the mandibular condyle. A case report. Br J Oral Maxillofac Surg 2002; 40:516–518.

35. Miyamoto H, Dance G, Wilson DF, Goss AN. Eosinophilic granuloma of the mandibular condyle. J Oral Maxillofac Surg 2000;58:560–562.

36. Bhaskar PB, White CS, Baughman RA. Eosinophilic granuloma of the mandibular condyle. A case report and management discussion. Oral Surg Oral Med Oral Pathol 1993;76:557–560.

37. Peckitt NS, Wood GA. Eosinophilic granuloma of the mandibular condyle. Br J Oral Maxillofac Surg 1988;26: 306–310.

38. Zachariades N, Anastasea-Vlachou K, Xypolyta A, Kattamis C. Uncommon manifestations of histiocytosis X. Int J Oral Maxillofac Surg 1987;16:355–362.

39. Tant L, Dourov N, Vanatoru P, Malevez C, Mayer R. Eosinophilic granuloma (histiocytosis X). Apropos of a case located at the level of the mandibular condyle. Acta Stomatol Belg 1984;81:181–204.

40. Makek M, Sailer HF. Eosinophilic granuloma of the mandibular condyle. Case report. J Maxillofac Surg 1980; 8:327–331.

41. Moenning JE, Williams KL, McBride JS, Rafetto LK. Resorption of the mandibular condyle in a 6-year-old child. J Oral Maxillofac Surg 1998;79:477–482.

42. Whitcher BL, Webb DJ. Treatment of recurrent eosinophilic granuloma of the mandible following radiation therapy. J Oral Maxillofac Surg 1986;44:565–570.

43. Putters T, de Visscher JGAM, van Veen A, Spijkervet FKL. Intralesional infiltration of corticosteroids in the treatment of localized Langerhans’ cell histiocytosis of the mandible: Report of known cases and three new cases. Int J Oral Maxillofac Surg 2005;34:571–575.

44. Nortje CJ, van Rensburg LJ, Thompson IO. Case report. Magnetic resonance features of metastatic melanoma of the temporomandibular joint and mandible. Dento-maxillofac Radiol 1996;25:292–297.

45. Johal AS, Davies SJ, Franklin CD. Condylar metastasis: A review and case report. Br J Oral Maxillofac Surg 1994;32:180–182.

46. Yoshimura Y, Matsuda S, Naitoh S. Hepatocellular carcinoma metastatic to the mandibular ramus and condyle: Report of a case and review of the literature. J Oral Maxillofac Surg 1997;55:297–306.

47. Ogasawara T, Kitagawa Y, Ogawa T, Yamada T, Yamamoto S, Hayashi K. Simple bone cyst of the mandibular condyle with severe osteoarthritis: Report of a case. J Oral Pathol Med 1999;28:377–380.

48. Dworkin SF, LeResche L (eds). Research diagnostic criteria for temporomandibular disorders: Review, criteria, examination and specifications, critique. J Craniomandib Disord Facial Oral Pain 1992;6:327–334.