Benign Bone Neoplasms Flashcards
Central Ossifying Fibroma is an unccomon benign neoplasm that has been confused with ________ due to female mandibular premolar-molar predilection.
focal cemento-osseous dysplasia
What is the cell of origin for Central Ossifying Fibroma?
questionable?
Thought to be: PDL or Odontogenic
True or False: Central ossifying fibromas are slow-growing neoplasms.
True
Radiographically, how can you differentiate between Cemento-Osseous Dysplasia and Central Ossifying FIbroma?
COD is in tooth bearing areas only (above IAN)
COF can occur in non-tooth bearing areas
Which is easier to remove: Central ossifying Fibromas or Cemento-osseous Dysplasias?
Fibromas: they come out as a whole (looks like a potato)
Dysplasia: chips out in pieces
What is the prognosis of Central Ossifying Fibroma?
excellent
uncommon recurrence
Which syndrome has several jaw lesions that are histologically consistent with central ossifying fibroma?
hyperparathyroidism-jaw tumor syndrome
Which bones are affected by osteoma?
membranous bones (bones of the head)
- surfaces of bone
- or inside the bone: dense bone islands
________ involvement is more common for Osteoma than gnathic lesions.
Paranasal Sinus (frontal, ethmoid, maxillary)
True or False: Tori and exostoses are histologically identical to osteomas.
True
An osteoma is composed of dense bone, with only minimal _____ elements.
marrow
Where are osteomas most often found?
in the mandibular BODY and CONDYLE of adults
less common: angle, coronoid, ramus
True or False: Osteomas involving the mandibular body are frequently found on the buccal surface adjacent to premolars.
False: LINGUAL surface adjacent to premolars or molars
Osteomas that involve the mandibular condyle will limit mouth opening and cause malocclusion. Often deviation will deflect the midline toward the _____ side.
unaffected
Osteomas appear radiographically as a _____ ______ mass.
circumscribed, sclerotic
What are the traits associated with Gardner Syndrome?
autosomal dominant inheritance= rare condition characterized by: -osteomas of the facial bones -intestinal polyps -abnormalities of teeth -epidermoid cysts -desmoid tumors (connective tissue)
____% of Gardner Syndrome patients will have impacted supernumerary teeth.
35
____% of Gardner Syndrome patients will have odontomas.
10
What is the clinical difference between an osteoma and an epidermoid cyst?
osteoma = hard
epidermoid cyst = fluctuant
What is the most significant aspect of Gardner Syndrome?
the development of precancerous polyps of the colon
colectomy is prophylactic
_____% of Gardner Syndrome patients will develop adenocarcinoma of the colon by age 30.
50%
How is Garnder Syndrome treated/managed?
- prophylactic colectomy
- cosmetic removal of cysts and osteomas
- genetic counseling
- frequent follow-up visits
True or False: Central Giant Cell Granuloma usually affects the mandible but does not cross the midline.
False…CROSSES the midline
The Giant Cell Tumor of Bone typically arises in bones and particularly in the ____ area. Pathologist feel this is histologically the same lesion as Central Giant Cell Granuloma.
knee
Central Giant Cell Granuloma has a ____ predilection.
female
True or False: Central Giant Cell Granulomas can become expansile.
True
CGCG is seen as a proliferation of _______ tissue with numerous ________ cells scattered throughout.
vascular granulation tissue (extravasated RBC)
multinucleated giant cells
Prognosis for Central Giant Cell Granuloma is ____ and treatment consists of aggressive ______.
good (15-20% recurrence)
curettage
There are ____ types of hyperparathyroidism. What are they?
two
- Primary
- Secondary
Primary Hyperparathyroidism is due to ________ and Secondary Hyperparathyroidism is due to _______.
Primary: parathyroid hyperplasia (inappropriate hormone secretion)
Secondary: renal failure (poor calcium retention)
What are the actions of Parathyroid Hormone?
- osteoclast activation
- increases calcium uptake by the kidneys
- increases vitamin D synthesis by the kidneys (thus promoting Calcium absorption from the gut)
True or False: Both forms of Hyperparathyroidism result in increased serum calcium.
True
What are the clinical features of hyperparathyroidism?
Groans, Stones, Bones, Moans, and Throans
Hyperparathyroidism results in a radiographical _______ trabecular pattern and a loss of _____.
“ground glass”
lamina dura
True or False: Long-standing renal failure can result in an enlargement of the jaws.
True (Renal Osteodystrophy)
“Brown Tumors” are associated with which condition?
Hyperparathyroidism (extravasated erythrocytes)
What is renal osteodystrophy?
unusual hyperplastic response of the bone in patients with poorly controlled secondary hyperparathyroidism
- common in longterm renal dialysis patients
- seen as prominent jaw enlargement
What is the treatment for hyperparathyroidism?
if primary: remove the source of the hormone secretion (parathyroid)
if secondary: control serum calcium via parathyroidectomy or renal transplant
fair prognosis
