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Oral Pathology Exam 3 > 5. Non-Odontogenic Cysts > Flashcards

5. Non-Odontogenic Cysts Flashcards

1
Q

What is the presentation and location of the Torus Mandibularis?

A
  • Usually bilateral, but can be unilateral in 10%
  • Pearl-like projections of the lingual body of the mandible in the premolar area
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2
Q

What is the Radiographic appearance of the Stafne Bone Cyst? (4)

A
  • Well defined circular/oval RL of posterior mandible near angle, BELOW mandibular canal, hyperostotic border
  • Can be superimposed on canal depending on angulation of beam
  • May be RL but NOT a true cyst
  • Not going to be in a place where most odontogenic neoplasms or cyst are, so it is not going to mimic any of them = Almost Radiographically Diagnostic
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3
Q

What is the pathogenesis of the Median Palatal Cyst?

A

Fissural cyst developing from residual epithelial rests trapped between the palatal sutures/shelves that fuse during embryogenesis

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4
Q

What appears as a RL dead center in the mandible?

A
  • Median Mandibular Cyst
  • Most MMC’s represent Large Periapical Cysts or OKC’s
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5
Q

Differential Diagnosis (5)

Solid lesion presenting as a RL in the globulomaxillary area

A
  • Adenomatoid Odontogenic Tumor (AOT)
    • Anterior maxilla, never past PM
    • Young persons
  • Central Giant Cell Granuloma
  • Desmoplastic Ameloblastoma
    • Only Ameloblastoma that loves this area, but not purely RL
  • Ameloblastic Fibroma
    • Can occur there but uncommon in anterior jaws
  • Odontogenic Myxoma
    • Can occur in any tooth-bearing area, but prefers posterior mandible
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6
Q

How does the Torus Palatinus appear on a radiograph?

A

Shows up as a RL 2x, not in the midline - artifact

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7
Q

What is the radiographic appearance of the Median Palatal Cyst?

A

Well demarcated midline palatal RL, but posterior to incisal canal area​

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8
Q

What population does the Torus Palatinus affect?

A

25% of the population

  • Female 2:1
  • Asians/Eskimos
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9
Q

What is the pathogenesis of Buccal Exostoses?

A

May be reactive to trauma from occlusion - bruxism pts

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10
Q

What is the Treatment for the Stafne Bone Cyst?

A

Observe Only

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11
Q

What was the theory on the etiology of the Median Mandibular Cyst?

A
  • In theory, a cyst of the symphysis arising from entrapped epithelium during embryonic fusion
  • In reality, no fusion takes place & there is no opportunity for epithelial entrapment because fusion occurs so deeply in mesenchyme, that the epithelium is destroyed so you don’t have epithelial rests
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12
Q

What is the clinical appearance of the Nasopalatine Duct Cyst? (4)

A
  • Most asymptomatic
  • Some expansile, painfull
  • Drainage out of papilla, can cause salty taste
  • Can show a bulge on the palatal or labial side
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13
Q

How does the Traumatic Bone Cyst present?

A
  • Hollow cavity in the mandible, also seen in the femur and tibia
  • Asymptomatic, occasionally painless swelling
  • Teeth are vital
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14
Q

What is the radiographic appearance of the Globulomaxillary Cyst (not real)?

A
  • Inverted pear-shaped RL in between the maxillary lateral & canine that diverges both roots
  • Globulomaxillary area = between maxillary lateral & canine
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15
Q

What is the most common non-odontogenic cyst?

A

Nasopalatine Duct Cyst

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16
Q

In what age group does the Median Palatal Cyst occur?

A

2nd decade

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17
Q

Differential Diagnosis (2)

Cystic lesion presenting as a RL in the globulomaxillary area

A
  • Odontogenic Keratocyst (OKC)
    • Can occur anywhere that teeth are forming
  • Lateral Periodontal Cyst
    • 2nd best area is maxillary
18
Q

What is the etiology of the Traumatic Bone Cyst?

A
  • Not a true cyst - not lined by epithelium
  • Trauma not a proven etiology
19
Q

What is the Cyst of the Incisve Papilla? (4)

A
  • A soft tissue variant of the Incisive Canal Cyst
  • The nerves & blood vessels come out of the incisive canal into soft tissue, into the anterior palate, right in the area of the incisve papilla
  • Presents as a painless soft swelling right in the midline of the incisive papilla
  • No bone involvement
20
Q

What is the treatment and prognosis for the Nasopalatine Duct Cyst? (3)

A
  • Enucleation/curettage
  • Recurrence not expected
  • Associated teeth vital
21
Q

What are most reported Globulomaxillary Cysts due to/show?

A

Problem with the lateral incisor

  • Miss this diagnosis because it normally is centered over the apex of the tooth, but due to the anatomy of the maxillary lateral incisor root, which diverges distopalatally in 70%
    • Cyst follows path of least resistance, and the sloped floor of nose will push the cyst distally
    • Then the cyst encounters the longer root of the canine & is diverted
  • Maxillary lateral incisor is also most likely to get dens en dente, which is bilateral in 10%
22
Q

What is the clinical presentation of Buccal Exostoses?

A
  • Buccal or palatal shelves of bone that look like bumps on the ginigiva
  • Usually bilateral, can be unilateral
23
Q

What is the differential diagnosis for the Median Canal Cyst? (2)

A
  • Tori are RO and bony hard, non-compressible
  • Salivary gland tumors are not midline
24
Q

What is the radiographic appearance of the Torus Mandibularis?

A

PANX projects it over the incisors

25
Q

What is the pathogenesis of the Stafne Bone Cyst?

A

Developmental Defect

  • Extension of submandibular gland tissue becomes hyperplastic, & starts to grow, pressing on the lingual cortex of the mandible creating an indentation
  • Eventually causes resorption of lingual cortex, pushing it’s way into the cortex,
  • It is not internal, inside the mandible, but it causes an indentation that shows up as an RL
26
Q

What is the behavior of the Torus Palatinus?

A

Begins growth ~ puberty and slowly enlarges, then stops growing

27
Q

What is the radiographic appearance of the Traumatic Bone Cyst? (5)

A
  • Purely RL
  • Upper Border - scalloped between roots
  • Lower Border - smooth/flat & ABOVE mandibular canal
  • Can occur in anterior or posterior mandible
  • Doesn’t like to be in 3rd molar area but can be
28
Q

Where are Nasopalatine Duct Cysts located?

A

Must be Midline Anterior Palate

29
Q

What is the diagnostic radiography of the Nasopalatine Duct Cyst?

A
  • Classically a heart shaped RL, > 6mm, between the roots of 8 and 9
  • RL with no RO, with a hyper-ostotic corticated border
30
Q

What is the clinical presentation of the Median Palatal Cyst?

A
  • MUST be a midline palatal swelling, usually compressible (soft) and big >2 cm
    • Occur further back on the hard palate than the incisive canal cyst
31
Q

What population can be affected with Stafne Bone Cysts?

A

90% Males > 40 yrs

32
Q

What are the rules for a normal incisive canal? (4)

A
  • 3-6 mm, but can reach 1 cm on occasion
  • Any asymptomatic Rl < 6 mm is considered WNL
  • Any RL > 1 cm is considered a cyst, and is treated, symptomatic or not
  • 6-10 mm RL is suspect and observed and treated if: swollen or symptomatic, draining fluids, bad taste
33
Q

What is the location of the Torus Palatinus?

A

Midline palate, in the area of the palatal raphe

34
Q

What are the ONLY 2 situations in which a Traumatic Bone Cyst can occur?

A
  1. Males (60%), 10 - 20 yr old
  2. Associated wtih Florrid Osseous Dysplasia
    • ​Black females > 40 yrs
    • TBC won’t occur in adults without FOD
35
Q

What population do Nasopalatine Duct Cysts affect?

A

Males > 40 years

36
Q

What is the pathogenesis of the Nasopalatine Duct Cyst?

A

Developmental Cyst derived from residual epithelium within the nasopalatine duct

37
Q

What population does Torus Mandibularis affect?

A
  • 8% of the population
    • Much less common than Torus Palatinus
  • More in Asians/Eskimos
38
Q

What was theorized etiology of the Globulomaxillary Cyst? (3)

A
  • In theory a, fissural cyst from entrapped epithelium between fusing median nasal and maxillary processes
  • Proved that there are no processes that fuse, they are just bumps that smooth out, thus no opportunity for epithelial entrappment
  • Always due to pathology of the teeth, usually within the lateral incisor, sometime the canine
39
Q

What is the single most common cyst that mimics the Globulomaxillary Cyst?

A

Periapical Cyst of the Lateral Incisor

​

40
Q

What is the Histology of the Nasopalatine Duct Cyst?

A
  • Lining of the Cyst is Not Diagnostic
    • Stratified squamous non-keratinizing
    • Pseudostratified columnar respiratory with goblet cells
    • Simple cuboidal or columnar
  • Cyst wall = diagnostic:
    • Large nerves, thick blood vessels & salivary gland tissue
    • All normal contents of the incisive canal
    • Can see hyaline cartilage, due to natural cartilage in the area of biopsy
41
Q

What is the location of the Stafne Bone Cyst?

A
  • Below the mandibular canal in the posterior area near the angle of the mandible, not near teeth
    • This isn’t where you find most odontogenic neoplasms or cysts = not in the differential
42
Q

What is the treatment and prognosis for the Traumatic Bone Cyst? (3)

A
  • Spontaneously resolve
  • Exploratory surgery following safe aspiration may speed this up by causing a clot to form which quickens healing
  • Do not recur

Oral Pathology Exam 3 (8 decks)

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