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Parotid gland squamous cell carcinoma invading the temporomandibular joint
Gary D Klasser1, Joel B Epstein, Robert Utsman
1Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612-7213, USA. gklasser@uic.edu
Background:
Tumor invasion of the temporomandibular joint from the parotid gland is rare. Practitioners should be able to differentiate tumor involvement from temporomandibular disorders (TMDs).
Case Description:
. The authors present case reports of two patients with parotid gland masses accompanied by pain, dysfunction and other symptoms not consistent with musculoskeletal disorders. In both cases, clinicians initially reached an incorrect diagnosis and treated the masses as if they were TMDs, which delayed a definitive diagnosis and provision of appropriate treatment.
Conclusions:
Dentists must take a thorough patient history, perform a detailed clinical examination and request proper radiographic imaging, when necessary, to render an accurate diagnosis and avoid mistreatment. Dentists who treat TMDs must recognize the possibility that a head or neck malignancy may manifest with symptoms and signs that mimic TMDs. If dentists are in doubt about a diagnosis, referral to the appropriate specialist should be considered.
Clinical Implications:
A thorough history, a comprehensive clinical examination and an understanding of salivary gland disorders should facilitate an accurate initial diagnosis, allowing delivery of the appropriate and necessary medical treatment.
