Calcifying Aponeurotic Fibroma of the Temporomandibular Joint in an Adult Patient: A Case Report

  • Jeon, Hye-Mi (Dental Clinic Center, Pusan National University Hospital) ;
  • Jeong, Sung-Hee (Department of Oral Medicine, School of Dentistry, Pusan National University) ;
  • Ahn, Yong-Woo (Department of Oral Medicine, School of Dentistry, Pusan National University) ;
  • Kim, So-Yeun (Dental Clinic Center, Pusan National University Hospital) ;
  • Jung, Kyung-Hwa (Dental Clinic Center, Pusan National University Hospital) ;
  • Kwon, Eun-Young (Dental Clinic Center, Pusan National University Hospital) ;
  • Ok, Soo-Min (Department of Oral Medicine, School of Dentistry, Pusan National University)
  • Received : 2019.02.22
  • Accepted : 2019.03.18
  • Published : 2019.03.30


Calcifying aponeurotic fibroma (CAF) is an uncommon benign soft-tissue fibroblastic tumor with characteristic histological features. It mainly occurs in the distal part of the extremities, such as the hands and feet, in children and adolescents. Males are twice as commonly affected as females. CAF exhibits local invasiveness, and hence, its recurrence rate is also high. Therefore, complete surgical excision is both diagnostic and therapeutic. The occurrence of CAF in the maxillofacial region, especially the temporomandibular joint (TMJ), is very rare, and this necessitates its differentiation from other TMJ neoplasms. The differential diagnosis of CAF requires microscopic examination. Herein, we report a rare case of CAF located at the left mandibular condyle, which was confirmed by histopathological analysis.

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Fig. 1. Preoperative clinical photograph of patient with localized swelling on left temporomandibular joint (arrow). The overlaying skin is normal in color.

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Fig. 3. Computed tomography (CT). (A) Axial CT image, (B) coronal CT image shows a non-specific soft tissue mass (white arrows) on the left temporomandibular joint and high density part. There is no adjacent bone involvement.

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Fig. 2. Panoramic radiograph reveals that there are no pathological findings.

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Fig. 4. Gross specimen. (A) Resection gross specimen shows a lobulated and circumscribed mass. (B) The sectioned specimen has a homogeneous yellowish white appearance.

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Fig. 5. Histologic examination. (A) The lesion demonstrates characteristic scattered foci of calcification (black arrows) (H&E stain, ×40). (B) Calcification area (black star) and collagenous stroma (black arrows) are observed (H&E stain, ×200). (C) Multinucleated giant cell (black star) is seen around the calcification area. Spindled fibroblasts are aligned linearly (black arrows) (H&E stain, ×200). (D) A local chondroid differentiation (black stars) reveals surrounded by peripheral less cellular and fibroblasic component (black arrow) (H&E stain, ×200).


Supported by : Pusan National University Hospital


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