6. Oral lesions and Anomalies II

Question 1

What is the origin of the thyroid gland and where does it end up

Answer 1

Origin= back of tongue

Ends at the front of the neck

Question 2

When in development does the thyroid gland migrate

Answer 2

1st trimester

Question 3

What is the name of the path the thyroid gland migrates down

Answer 3

thyroglossal duct

Question 4

What is the result of improper thyroig gland migration

Answer 4

lingual thyroid

Question 5

Describe the clinical appearance of a lingual thyroid

Answer 5

Nodular mass
red/pin
smooth vascular appearance

Question 6

Where is the location of the lingual thyroid

Answer 6

midline base of the tongue

Question 7

What is the gender predilection for lingual thyroid

Answer 7

female

Question 8

Lingual thyroid may lead to what issue

Answer 8

• Dysphagia
• Dyspnea
• Dysphonia

Question 9

Symptoms of lingual thyroid may develop when

Answer 9

pregnancy

puberty

Question 10

In how many percent of cases of lingual thyroid is normal thyroid tissue absent

Answer 10

70%

Question 11

Lingual thyroid is an important cause (etiology) of….

Answer 11

infantile hypothyroidism

Question 12

What is the main part of the body that takes up iodine

Answer 12

thyroid gland

Question 13

What is the treatment for lingual thyroid

Answer 13

• Thyroid hormone therapy
• Excision
• Radioactive iodine ablation

Question 14

Lingual thyroid mimic

Answer 14

hemangioma
lymphangioma
lymphoid hyperplasia

Question 15

Location of a thyroglossal duct cyst

Answer 15

midline of neck

Question 16

Cause of thyroglossal duct cyst is

Answer 16

Duct should disappear after the migration of the thyroid gland down to the neck is complete

Question 17

What is the treatment for a thyroglossal duct cyst

Answer 17

excision

Question 18

What are the two groups of vascular anomalies

Answer 18

• Vascular tumors (hemangiomas)

- Vascular malformations

Question 19

(Vascular tumors/Vascular malformations) demonstrate proliferative activity

Answer 19

vascular tumors

Question 20

(Vascular tumors/Vascular malformations) grow commensurately with the child

Answer 20

vascular malformations

Question 21

How are vascular malformations classified

Answer 21

by their blood vessel type

Question 22

Different categories of vascular tumors are

Answer 22

• Infantile hemangioma
• Congenital hemangioma
• Tuft angioma
• Kaposiform hemangioendothelioma

Question 23

What are the different vascular malformations

Answer 23

Slow flow

• Capillary malformations
• Venous malformations
• Lympatic malformations

Fast flow
-Arteriovenous malformations

Question 24

A hemangioma present at birth is called a

Answer 24

congenital hemangioma

Question 25

Infantile hemangiomas develop when

Answer 25

usually appear 2-3 weeks after birth and grow rapidly over the next 6 months

Question 26

_% of infantile hamangiomas occur in the head and neck region

Answer 26

60

Question 27

Common sites for infantile hemangiomas in the head and neck region are

Answer 27

lips, tongue, buccal mucosa

Question 28

Gender predilection for infantile hemangioma

Answer 28

female

Question 29

Describe the growth pattern of infantile hemangioma

Answer 29

- Rapid growth followed by period of involution | - There is a proliferation and an involution phase

Question 30

How long can it take for hemangiomas to completely involute

Answer 30

50% involute in 5 yrs 70% 7 yrs 90% in 9 years

Question 31

What is the difference between infantile and congenital hemangiomas

Answer 31

There is not proliferative phase with congenital hemangiomas- they are fully formed at birth

Question 32

Suferficial lesions in hemangiomas are _ in color while deep lesions are _ in color

Answer 32

red...blue

Question 33

Complications of infantile hemangiomas are

Answer 33

- Ulceration - Bleeding - Infection - Scars - May interfere with function/airway obstruction - Kasabach-Merritt Syndrome

Question 34

Whar is Kasabacj Merritt Syndrome

Answer 34

Rare vascular lesion characterized by - Enlarging hemangioma - Disseminated intravascular coagulation (DIC) - Thrombocytopenia - Large periocular lesions (ocular disease) - Multiple cutaneous facial hemangiomas may be associated with visceral lesiosn)

Question 35

Infantile hemangioma treatment

Answer 35

- Surgery - Laser - Propranolol - Interferon **Many case tx is not requires and will involute without complications