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15 Odontogenic Cysts & Tumors Flashcards

1
Q

What is a dentigerous cyst?

A

A cyst that originates from the separation of the fillocle from around the crown of a developing, unerupted tooth.

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2
Q

Where does fluid accumulate in a dentigerous cyst?

A

Between the Reduced Enamel Epithelium and Crown of unerupted tooth

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3
Q

What is the most common developmental cyst?

A

Dentigerous cyst

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4
Q

What tooth is most commonly affected by a dentigerous cyst?

A

mandibular 3rd molars

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5
Q

How do dentigerous cysts appear on radiograph?

A
  1. unilocular radiolucency
  2. well-defined
  3. sclerotic border
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6
Q

This RL is fluid between the REE and crown of the unerupted tooth. What is your diagnosis?

A

Dentigerous cyst

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7
Q

Pathology is asymptomatic, has very slight cortical expansion, and the tooth is unerupted. What is your diagnosis?

A

Dentigerous cyst

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8
Q

What is your differential diagnosis for a unilocular RL around an unerupted, impacted tooth?

A
  1. Dentigerous cyst
  2. Odontogenic keratocyst
  3. Ameloblastoma
  4. Central cell granuloma
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9
Q

What is an eruption cyst?

A

A cyst that originates from the separation of the follicle from the crown of an erupting tooth.

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10
Q

What is the difference between a dentigerous cyst and eruption cyst?

A

A dentigerous cyst is in an unerupted tooth still in bone, and an eruption cyst is involving a tooth that has exited bone but not soft tissue.

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11
Q

What patient demographic will you typically see eruption cysts?

A

Patients younger than 10 years old

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12
Q

What is an eruption hematoma?

A

An eruption cyst that experienced trauma and has bleeding into the cystic fluid

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13
Q

Pt is young. What could these be?

A

Eruption cysts (or eruption hematomas)

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14
Q

What is this if radiograph shows the tooth only has soft tissue overlying the crown?

A

eruption cyst (or eruption hematoma)

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15
Q

What cells give rise to an odontogenic keratocyst?

A

Cell rests of the dental lamina

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16
Q

Odontogenic keratocysts tend to grow in what direction?

A

Anterior to posterior

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17
Q

Odontogenic keratocysts are associated with what syndrome?

A

Nevoid Basal Cell Carcinoma Syndrome

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18
Q

Odontogenic keratocysts have a ___% recurrence rate.

A

30%

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19
Q

If a patient age 20 or younger has an OKC, he or she should be further evaluated to rule out what syndrome?

A

Gorlin Syndrome (aka Nevoid Basal Cell Carcinoma Syndrome)

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20
Q

Growth in an anterior-posterior direction in a 20 yr old pt. What is this?

A

Odontogenic Keratocyst (aka OKC)

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21
Q

Upon surgery there was a “cheese-like” substance found inside the cavity. What is your diagnosis?

A

Keratocystic Odontogenic Tumor (aka odontogenic keratocyst)

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22
Q

Pt has rib abnormalities, multiple documented basal cell carcinomas, and this radiographic finding. What is your diagnosis of the finding, and their syndrome?

A

Radiographic finding: odontogenic keratocyst

Syndrome: Gorlin syndrome

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23
Q

What are four characteristics of Gorlin Syndrome?

A
  1. Multiple basal cell carcinomas
  2. Odontogenic keratocyst(s)
  3. Calcification of Falx Cerebri
  4. Splayed or Bifid ribs
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24
Q

This pathology is autosomal dominant and usually presents OKCs and basal cell carcinomas. What is it?

A

nevoid basal cell carcinoma syndrome

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25
Q

What kind of epithelium lines an odontogenic keratocyst?

A

Parakeratinized

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26
Q

What kind of epithelium lines an orthokeratinized odontogenic cyst?

A

orthokeratinized

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27
Q

Orthokeratinized odontogenic cysts appear like what on radioraph?

A

Dentigerous cyst - need biopsy to differentiate

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28
Q

Upon radiograph you think it might be a dentigerous cyst, but histology shows this. What is the diagnosis?

A

Orthokeratinized odontogenic cyst

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29
Q

What is the soft tissue counterpart of the lateral periodontal cyst?

A

Gingival Cyst of the Adult

30
Q

Gingival cyst of the adult arises from what cells?

A

Rests of dental lamina

31
Q

Where does gingival cyst of the adult usually present?

A

Mandibular canine/premolar area

32
Q

What is this?

A

Gingival cyst of the adult

33
Q

Why is this not a mucocele? What is it?

A

Not a mucocele because those can NOT occur on gingiva. It’s really a Gingival Cyst of the Adult

34
Q

What is the intrabony counterpart of the gingival cyst of the adult?

A

lateral periodontal cyst

35
Q

Where do lateral periodontal cysts usually present?

A

mandibular canine/premolar/lat. incisor area

36
Q

Usually unilocular, what is lateral periodontal cyst called when multilocular?

A

Botryoid Odontogenic Cyst

37
Q

What is this counterpart of gingival cyst of the adult?

A

lateral periodontal cyst

38
Q

What is this?

A

lateral periodontal cyst

39
Q

Diagnosis.

A

Lateral periodontal cyst

40
Q

What is this? Teeth are vital.

A

lateral periodontal cyst

41
Q

What is also called a Gorlin Cyst?

A

Calcifying Odontogenic Cyst

42
Q

Compared to Gingival Cysts of the Adult, where do Calcifying Odontogenic Cysts mostly occur?

A

Incisor/canine area of either mx or md

43
Q

What radiographic feature(s) do calcifying odontogenic cysts have?

A
  1. Unilocular
  2. RL
  3. 50% have RO specks within lesion
  4. 1/3 associated with unerupted tooth
44
Q

What calcifies in Calcifying odontogenic cysts?

A

Ghost cells

45
Q

What is this?

A

Calcifying odontogenic cyst

46
Q

Diagnosis.

A

Calcifying odontogenic cyst

47
Q

Tricky, but what could this be based on the RO specks associated with the unerupted tooth?

A

Calcifying odontogenic cyst

48
Q

Glandular odontogenic cysts have a predilection for what area of mouth?

A

Anterior mandible

49
Q

What is the most recently added pathology to the topic of developmental cysts (in 1988)?

A

glandular odontogenic cyst

50
Q

If these radiographic findings are associated with a salivary gland malformation, what could this be?

A

glandular odontogenic cyst

51
Q

Which pathology characteristically develops on the buccal bifurcation aspect of the mandibular first permanent molar?

A

Buccal Bifurcation Cyst

52
Q

What demographic do buccal bifurcation cysts appear?

A

children, usually around 10 yrs

53
Q

What are radiographic findings of Buccal Bifurcation Cysts?

A
  1. roots are tipped lingually
  2. unilocular RL on buccal side of tooth
54
Q

What is this?

A

buccal bifurcation cyst

55
Q

What is this?

A

buccal bifurcation cyst

56
Q

What is the most common clinically significant odontogenic tumor?

A

Ameloblastoma

57
Q

What are the three types of ameloblastomas?

A
  1. Conventional solid or multicystic (85%)
  2. Unicystic (14%)
  3. Peripheral (soft tissue)
58
Q

A large ameloblastoma loculation is described as what?

A

soap bubbles

59
Q

Smaller ameloblastoma loculations are described as?

A

Honeycombed

60
Q

What are the two most common patterns of ameloblastomas?

A

Follicular and Plexiform

61
Q

Desmoplastic ameloblastomas have a predilection for what area of the mouth?

A

Anterior maxilla

62
Q

Ameloblastoma shares what histologic similarities with odontogenic keratocyst?

A
  1. palisading, hyperchromatic basal layer
63
Q

What is this “soap bubble” finding?

A

ameloblastoma

64
Q

What is this? Histology shows reversed palisading, hyperchromatic basal layer.

A

ameloblastoma

65
Q

Not as common, but what could you put on your differential for “bump on the gums” (3 Ps and F)?

A

Peripheral ameloblastoma

66
Q

Painless, non-ulcerative, sessile lesion on retromolar pad. What could this be?

A

peripheral ameloblastoma

67
Q

This is not one of the 3 P’s or a fibroma, and basal layer is reversed. What is this?

A

peripheral ameloblastoma

68
Q

This pathology is usually circumscribed, unilocular, and involving the crown of an unerupted canine.

A

Adenomatoid odontogenic tumor (AOT)

69
Q

Where does the RL extend to, in adenomatoid odontogenic tumors?

A

Beyond the CEJ of the tooth - unlike dentigerous cysts which are higher on the tooth

70
Q

Tumor has a thick, fibrous capsule upon enucleation. What is this?

A

Adenomatoid odontogenic tumor

OMF Pathology (21 decks)

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