Pigmented villonodular tenosynovitis of the temporomandibular joint

A case report of pigmented villonodular tenosynovitis involving the temporomandibular joint is presented. The lesion had destroyed the ascending ramus and condyle of the mandible, anterior cartilaginous wall of the external auditory meatus, and a large part of the squamous portion of the temporal bone. Surgery included resection of a portion of the mandible, temporal squama, and dura of the temporal lobe with replacement by a fascia temporalis graft. Four years postoperatively, the patient is free of any evidence of recurrent disease. A discussion of the differential diagnosis of an infratemporal mass, natural history, and pathology of pigmented villonodular tenosynovitis are discussed herein.