Abstract
INTRODUCTION: Calcium pyrophosphate crystal deposition disease, also known as pseudogout, is a condition in which calcium pyrophosphate dihydrate (CPPD) crystals accumulate in the joint tissues, causing inflammation and arthritis. CPPD crystals are known to accumulate due to trauma; however, pseudogout developing after open temporomandibular joint (TMJ) surgery has not been previously reported. PRESENTATION OF CASE: A 54-year-old male presented to our hospital with complaints of discomfort and swelling in the front of the left ear. Magnetic resonance imaging (MRI) revealed a TMJ tumor, which was removed under general anesthesia, and a pathological diagnosis of synovial chondromatosis (SC) was established. Seven months after the surgery, recurrence was suspected based on an MRI scan. However, the patient had few subjective symptoms; therefore, we decided to continue to observe the patient without specific treatment. Twenty two months after the surgery, the mass was found to have increased in size; therefore, a second surgery was performed. Pathological examination revealed CPPD deposition, which led to the rare diagnosis of CPPD crystal deposition in the left TMJ. DISCUSSION: The development of CPPD in this patient may have been triggered by mechanical stimulation from intra-articular free bodies. However, because CPPD was not detected in the original excised specimen, it is more likely that the surgical invasion during the original procedure promoted the deposition of CPPD crystals. CONCLUSION: This case demonstrates the rare possibility of CPPD development after TMJ surgery. This emphasizes the importance of long-term follow-up after open TMJ surgery to monitor the possibility of CPPD-related complications.