Temporomandibular Joint Ganglion Cyst: A Unique Case of Complete Resolution Following Subtotal Excision

Ganglion cysts of the temporomandibular joint (TMJ) are a rare entity. Most often, ganglions present in anatomic regions, such as the hand, wrist, knee, foot, or ankle. Ganglion cysts are pseudocysts characterized by a fibrous connective tissue lining that lacks synovial cells and contains a thick gelatinous material. The etiology remains unclear, but might involve myxoid degeneration or softening of the collagen and connective tissue after long-term irritation and trauma. Ganglion cysts of the TMJ most commonly present as a swelling in the preauricular region, produce limited or no pain, and often have no effect on mouth opening. Because of the infrequent involvement of ganglion cysts with the TMJ and the nonspecific clinical presentation, the diagnosis is challenging. Diagnostic imaging tools, such as computed tomography and magnetic resonance imaging, have aided in diagnosis; however, only histopathologic examination will lead to a definitive diagnosis. The precise management of ganglion cysts of the TMJ remains uncertain owing to the uncommon appearance of these lesions. Treatment has focused on surgical excision without regard for lesion size or symptoms. This seems to be due to the decreased rate of recurrence after complete excision and microscopic examination providing the best method for a definitive diagnosis. This report describes a unique case of an 88-year-old woman with a large multilocular ganglion cyst of the right TMJ that completely resolved approximately 1.5 years after subtotal cystectomy.