Tophaceous Calcium Pyrophosphate Dihydrate Deposition Disease of the Temporomandibular Joint: A Case Report

Background Calcium pyrophosphate dihydrate deposition disease (CPPD) is an uncommon crystal‐induced arthropathy that typically affects large joints and rarely involves the temporomandibular joint (TMJ). In its tophaceous form, CPPD may present as a calcified periarticular mass with tumour‐like features and associated bone destruction, mimicking neoplastic disease. Case Presentation A 64‐year‐old woman presented with progressive preauricular pain and limited mouth opening. Cone beam computed tomography revealed a large hyperdense lesion involving the left TMJ, associated with condylar erosion and extension toward the middle cranial fossa. Surgical exploration demonstrated abundant whitish, granular, friable material within the joint space. Results Histopathological analysis showed basophilic crystalline deposits, and polarized light microscopy confirmed birefringent crystals consistent with CPPD. The patient underwent lesion removal with condylectomy and reconstruction, resulting in improved function and symptom relief. No recurrence was observed during follow‐up. Conclusions Tophaceous CPPD of the TMJ is a rare condition that may mimic neoplastic disease clinically and radiographically. Accurate diagnosis requires clinicopathological correlation, and surgical management can achieve favourable functional outcomes.