Extradural extension of temporomandibular joint ganglion cyst.

OBJECTIVE: To describe a rare case of temporomandibular joint (TMJ) ganglion cyst with extradural extension toward the cranial base and to discuss diagnostic and surgical considerations. METHODS: A 77-year-old female presented with facial pain and temporomandibular joint dysfunction. Magnetic resonance imaging and computed tomography revealed a cystic lesion arising from the superior compartment of the TMJ with extradural extension through the temporal bone. Surgical treatment was performed using a combined maxillofacial–neurosurgical approach. The lesion was completely excised and submitted for histopathological analysis. RESULTS: Histopathological examination demonstrated a cystic lesion without synovial lining, consistent with a ganglion cyst. Postoperative recovery was uneventful, and the patient experienced improvement in symptoms. No neurological complications were observed. CONCLUSION: Ganglion cysts of the TMJ with extradural extension are exceptionally rare and may pose diagnostic and therapeutic challenges. Accurate anatomical localization and histopathological differentiation are essential for appropriate classification and management. A multidisciplinary surgical approach may be required in cases involving cranial base extension.