12- Exophytic Lesion Flashcards

1
Q

What are exophytic lesions?

A

They are the majority of soft connective tissue “tumors” presenting in the mouth are benign.
* they may represent growths that are reactive to an inflammatory stimulus, hamartomatous growths, or neoplasms.

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2
Q

What is a harmartoma?

A

It is an overgrowth of mature cells & tissues which are normally presented in the affected tissue (abnormal growth of tissue in a normal location)

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3
Q

What is a neoplasm?

A

They are new & abnormal growth of tissue in some part of the body, especially as a characteristic of cancer.

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4
Q

What are the lesion descriptions used?

A

LDS SCC:

Location: Gingiva, buccal mucosa, hard palate etc
Distribution: Single, multiple
Size/Shape: Give measurement in mm or cm
Surface texture: Smooth, papillary, verruciform
Colour: Uniformly one colour, multiple different colours
Consistency: Cannot assess based on clinical photograph, hard, soft, firm, doughy

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5
Q

What is pedunculated?

A

Think of it like a skin tag. Almost has a narrow base to it.

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6
Q

What are the common soft tissue growths?

A

1.) Pyogenic granuloma
2.) Peripheral ossifying fibroma
3.) Peripheral giant cell granuloma
4.) Fibrous hyperplasia (fibroma)

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7
Q

What is a pyogenic granuloma?

A

It is a reactive vascular proliferation due to chronic irritation + represents granulation tissue.

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8
Q

what is a granulation tissue?

A

connective tissue & microscopic blood vessels that form on the surfaces of a wound from the healing processes.

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9
Q

Where can we typically find a pyogenic granuloma?

A

the lips, tongue & buccal mucosa + 75% on gingiva

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10
Q

What are the clinical features of a pyogenic granuloma?

A
  • It has a erythematous, hemorrhagic mass
  • may have ulcerated or pedunculated appearance
    -often known with pregnancy (pregnancy tumour)
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11
Q

What is a treatment of pyogenic granuloma?

A
  • Surgical excision
  • Clean/scale adjacent teeth
  • May recur if cause not removed
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12
Q

What is a peripheral ossifying fibroma?

A

It is an inflammatory proliferation fibrous tissue which has a component of bone or cementum `

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13
Q

Why are peripheral ossifying fibromas only derived from periodontal fibers?

A

Because they can only occur on the gingiva

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14
Q

Who is most likely to see a peripheral ossifying fibroma?

A

Females + teenagers

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15
Q

What are some of the treatments used for peripheral ossifying fibroma?

A

1.) Surgical removal
2.) Clean/scale adjacent teeth
3.) Clow follow-up due to high recurrence.

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16
Q

What are some clinical features of peripheral ossifying fibroma?

A

Painless red/pink mass.
May be ulcerated. p.20

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17
Q

What is a peripheral giant cell granuloma?

A

It is a reactive fibrous lesion

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18
Q

How are peripheral giant cell granulomas formed?

A

Due to local irritation:
- overhanging restorations
- plaque/calculus buildup

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19
Q

Who is most prone to acquiring peripheral giant cell granuloma?

A

Females > males

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20
Q

What are the clinical findings of a peripheral giant cell granuloma?

A

Dark blue + purple nodule.

21
Q

What are the radiograph features of a peripheral giant cell granuloma?

A

May cause resorption of underlying bone.

22
Q

What are the treatments needed for a peripheral giant cell granuloma?

A
  • Surgical excision
  • Cleaning/scaling adjacent teeth
23
Q

What is ruled out if a peripheral giant cell granuloma is intraosseous?

A

hyperparathyroidism

24
Q

What is fibrous hyperplasia?

A

It is formation of fibrous connective tissue due to chronic low grade irritation.

25
Q

How does a fibrous hyperplasia appear clinically?

A

It is usually seen as a pink mass.

26
Q

What are the different names of a fibrous hyperplasia?

A
  • Epulis fissuratum
  • Leaf fibroma
27
Q

What is an epulis fissuratum?

A

It is a fibrous hyperplasia in context of an impinging denture

28
Q

What is a leaf fibroma?

A

It is a flattened, exophytic palatal lesion found under a denture

29
Q

What is fibroma?

A

A mass of collagen formed as a creative response which is often from acute or repeated trauma
- cheek biting is common
- forms a cycle of trauma, & further growth

30
Q

Who is affected by fibroma? & at what age?

A

men + women. Around the 4th=6th decade most common, but can affect any age.

31
Q

Where can we typically find the fibroma?

A

In the buccal mucosa, lip, tongue, in site predilection

32
Q

What are the clinical appearances of Fibroma?

A
  • They are smooth surfaces
  • Pink/normal colour
  • may be secondarily ulcerated
33
Q

What kind of treatment is needed for fibroma?

A

Surgical removal

34
Q

How can leaf fibroma’s arise?

A

From irritation under a denture

35
Q

Who is prone to obtain a leaf fibroma?

A

Females > males
Older patients (with dentures) are more common.

36
Q

Where can typically find a leaf fibroma

A

On the hard palate

37
Q

What is the clinical appearance of leaf fibroma?

A

pink + pedunculated lesion: narrow base.

38
Q

What are treatments needed for leaf fibroma?

A

Surgical removal + denture adjustments may be required.

39
Q

In what individual can we commonly see an Epulis Fissuratum?

A
  • Middle aged & older patients
40
Q

Where can we commonly see Epulis Fissuratum?

A

On the anterior vestibule than posterior vestibule (p.37)

41
Q

What are the clinical appearances of an Epulis Fissuratum?

A

Multiple folds of pink linear tissue.

42
Q

What are the treatments needed for an Epulis Fissuratum?

A

Surgical removal + remake of dentures

43
Q

What are Giant cell Fibroma?

A

They are like normal fibromas, BUT are NOT related to trauma or irritation.

44
Q

Where can we commonly see giant cell fibroma?

A

On the gingiva.

45
Q

How does a giant cell fibroma differ from a normal fibroma histologically?

A

Giant cell fibroma has the presence of LARGE fibroblasts hence “Giant Cells” (p.39)

46
Q

What is a giant cell fibroma often mistaken for?

A

For a papilloma

47
Q

What is a retrocuspid papilla?

A

It is a small fibrous gingival nodule (p.41)

48
Q

Where are the retrocuspid papilla typically found on ?

A

Found on the lingual gingiva + behind mandibular canines (often bilateral + histologically identical to giant cell fibroma)

49
Q

What kind of treatment is needed for a retrocuspid papilla?

A

No treatment required + reinforce to patient the benign nature of condition.