Pseudogout: a metabolic disease invading the skull base

Tophaceous pseudogout (TP) is a metabolic disease generally affecting fibrocartilaginous joints with local destruction and associated mass lesion. We present a rare case of TP involving the skull base from temporomandibular joint (TMJ). The patient, a middle-aged man, presented with a painful swelling in the preauricular region with TMJ impairment and radiological evidence of a dumbbell mass in the infratemporal and middle cranial fossa. A combined approach by neurosurgical and maxillo-facial teams allowed to obtain complete excision and functional reconstruction of TMJ. This rare disease of the infratemporal fossa has to be considered in the differential diagnosis of middle cranial fossa lesions.