累及颅底的颞下颌关节滑膜软骨肉瘤切除与重建：附1例报告

Resection of synovial chondrosarcoma of temporomandibular joint involving the skull base with simultaneous reconstruction: report of one case

滑膜软骨肉瘤(synovial chondrosarcoma,SCS)是一种软骨性恶性肿瘤,极其罕见,可原发或继发于滑膜软骨瘤病。源于颞下颌关节(temporomandibular joint,TMJ)的SCS仅见3例报道。本文报告1例罕见的累及颞下间隙且破坏颅底的TMJ-SCS,手术利用数字导板确定肿瘤边界并将其切除,同期用髂骨瓣修复颅底、带蒂锁骨瓣重建髁突和颞深筋膜脂肪瓣作为骨组织间置物。术后随访1 a,患者面型对称,开口度22 mm;影像学检查显示局部无复发和骨转移,但出现肺转移。

Synovial chondrosarcoma（SCS） is a rare malignant cartilaginous tumor that arises from synovial chondromatosis（SCM） or de novo. To our knowledge, only three previously studies reported its involvement of temporomandibular joint（TMJ）. Here, we present a case of a 56-year old woman with a SCS of TMJ involving the infratemporal space and the skull base. The lesion was resected with the aid of the digital template, while the skull base and the condyle were immediately reconstructed with ilium bone flap（IBF） and pedicled sternoclavicular joint（SCJ）. There was no clinical or imaging sign of local recurrence and bone metastasis during 1-year follow-up period, but metastasis to lung was observed.