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Clinical Problem Solving | Pathology

Unilateral Ear and Temporomandibular Joint Discomfort QUIZ

Alexander Lanigan, MD1; Andrew J. Tompkins, MD2; Arnaldo Rivera, MD2,3
[+] Author Affiliations
1San Antonio Military Medical Center, San Antonio, Texas
2Department of Otolaryngology–Head and Neck Surgery, Fort Belvoir Community Hospital, Fort Belvoir, Virginia
3Department of Otolaryngology–Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
JAMA Otolaryngol Head Neck Surg. 2014;140(9):873-874. doi:10.1001/jamaoto.2014.1472.
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A, Computed tomographic image revealing dehiscence of the right glenoid fossa, erosion of the anterior external auditory canal, temporomandibular joint, and middle cranial fossa. The arrow indicates soft-tissue mass with bony erosion noted anteriorly into glenoid fossa and superiorly approaching the cranial vault. B, Magnetic resonance image (MRI) of the lesion displaying intermediate signal intensity on T1- and T2-weighting and enhanced with gadolinium administration. The arrow indicates coronal T1-weighted MRI postgadolinium with fat saturation revealing avid enhancement of soft-tissue mass superior and posterior to glenoid fossa. C, Multinucleated cells dispersed in a somewhat lobular pattern (hematoxylin-eosin, original magnification ×40).

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