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AU18: Oral Path 2 > Benign Mesenchymal Tumors > Flashcards

Benign Mesenchymal Tumors Flashcards

1
Q

What are the possible tissues of origin for mesenchymal tumors?

A
  1. Fibrous
  2. Adipose
  3. Nerve
  4. Blood
  5. Lymph
  6. Muscle
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2
Q

What are the six benign mesenchymal tumors with fibrous origin?

A
  1. Fibroma
  2. Inflammatory fibrous hyperplasia
  3. Inflammatory papillary hyperplasia
  4. Pyogenic granuloma
  5. Peripheral giant cell granuloma
  6. Peripheral ossifying fibroma
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3
Q

T/F: A frenal tag is an example of a fibroma.

A

True

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4
Q

Where are fibromas often seen?

A

Buccal mucosa/tongue

Dome shaped with smooth/slightly papillary surface

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5
Q

What is a common lesion that involves bilateral popular lesions on the gingiva lingual to the mandibular canines?

A

Retrocuspid papilla (fibroma)

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6
Q

T/F: Recurrence of fibromas after conservative excision is rare.

A

True

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7
Q

Which fibrous tumor is often seen in the flange of ill-fitting denture?

A

Inflammatory fibrous hyperplasia

Denture epulis, epulis fissuratum, denture-induced fibrous hyperplasia

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8
Q

What is the treatment for inflammatory fibrous hyperplasia?

A

Conservative excision and remake denture

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9
Q

What are some major causes of inflammatory papillary hyperplasia?

A

Ill-fitting maxillary denture, poor denture hygiene, wearing denture 24/7

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10
Q

Numerous asymptomatic red papules are seen in the palate of a denture patient. The patient claims they have been leaving their denture in overnight. Diagnosis?

A

Inflammatory papillary hyperplasia

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11
Q

What are some histopathological features of inflammatory papillary hyperplasia?

A

Papillary surface with edema

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12
Q

T/F: Candida is common on top of inflammatory papillary hyperplasia.

A

True

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13
Q

Which reactive tumor of fibrous origin will often be seen in pregnant women as a response to local irritation/trauma?

A

Pyogenic granuloma

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14
Q

T/F: Pyogenic granuloma is due to an infection.

A

FALSE

Due to trauma. Not a true granuloma

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15
Q

T/F: Pyogenic granulomas grow slowly.

A

False

Rapid growth, painless, red, often ulcerated

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16
Q

What is the most common intraoral site for a pyogenic granuloma?

A

Gingiva

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17
Q

What are the three possible lesions that can grow out of a socket?

A
  1. Epulis granulomatosa
  2. Lymphoma
  3. Metastatic disease
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18
Q

What looks very similar to a pyogenic granuloma but is seen in an extraction socket?

A

Epulis granulomatosa

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19
Q

What type of tissue is seen in pyogenic granuloma?

A

Vascular granulation tissue

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20
Q

What are the clinical features of peripheral giant cell granuloma?

A

Painless, dusky purple-red

Only found on gingiva of alveolar ridge

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21
Q

Radiographic cupping of the underlying bone is seen in which benign tumor of fibrous origin?

A

Peripheral giant cell granuloma

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22
Q

What are the clinical features of a peripheral ossifying fibroma?

A

Painless, firm, and pink

Found only on gingiva

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23
Q

T/F: Variable amounts of calcification will be seen in peripheral giant cell fibromas.

A

False

Peripheral ossifying fibroma

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24
Q

What are the three possible fibrous tumors that will be seen on the gums?

A

3 P’s

  1. Pyogenic granuloma - pregnant
  2. Peripheral giant cell granuloma - purple-red
  3. Peripheral ossifying fibroma - pink, calcifications
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25
Q

A __________ is a slow-growing, non-tender tumor often seen fat tissue of adult patients.

A

Lipoma

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26
Q

T/F: Lipomas will be firm to palpation.

A

False

Soft, doughy

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27
Q

T/F: Lipomas often recur and can turn malignant.

28
Q

What are the five benign mesenchymal tumors of nerve tissue?

A
  1. Traumatic neuroma
  2. Neurilemoma (schwannoma)
  3. Neurofibroma
  4. Melanotic neuroectodermal tumor of infancy
  5. Granular cell tumor
29
Q

T/F: A traumatic neuroma is a true neoplasm.

A

False

It is a reaction to the sectioning of a nerve

30
Q

T/F: Most oral traumatic neuromas are painful.

A

False

25-30% are painful

31
Q

Where are common oral sites for traumatic neuromas?

A

Tongue and buccal vestibule (esp mental foramen area)

32
Q

What is a neurilemoma?

A

Benign tumor of Schwann cell origin

33
Q

What are the most common areas for neurilemomas in the mouth?

A

Lips, tongue, buccal mucosa

34
Q

T/F: Neurilemoma can occur centrally within the bone.

35
Q

What type of tumor can cause radiographic ballooning of the inferior alveolar canal in a unilocular or multilocular pattern?

A

Neurilemoma or neurofibroma

36
Q

Neurilemoma can present with two types of tissues histopathologically. What are those tissues?

A

Antoni A - Palisaded nuclei around verocay bodies

Antoni B - disorganized myxoid

37
Q

T/F: The majority of neurofibromas are associated with neurofibromas.

A

False

90% solitary
10% multiple with neurofibromatosis

38
Q

T/F: Schwannomas are unencapsulated.

A

False

Neurofibromas are unencapsulated

39
Q

What is the most common location for a neurofibroma?

40
Q

What is a histopathological marker of neurofibroma?

A

Mast cells with S-100 protein

41
Q

T/F: Nerofibromas are encapsulated.

A

False

Demarcated but not encapsulated

42
Q

What are the three different types of Neurofibromatosis?

A

NF1 - mainly neurofibromas (Von Recklinghausen)

NF2 - mainly schwannomas

Schwannomatosis - mainly schwannomas

43
Q

T/F: The majority of patients with NF1 will have oral findings.

A

True (70-90%)

Neurofibromas on tongue, gingiva, bone

44
Q

T/F: Lisch nodules in the eyes are often seen in NF1 patients.

45
Q

T/F: Cafe-au-lait spots are diagnostic of NF1.

A

True

Must be more than 5mm in children (15mm in adults) and there must be six or more.

This combined with any other criteria (including genetics) will be diagnostic

46
Q

What is a plexiform neurofibroma?

A

Massive pendulous lesion associated with NF1

Feels like bag of worms

47
Q

T/F: Freckling in armpits (axial) and groin can be diagnostic of NF1.

48
Q

What is the prognosis of NF1?

A

Fair/guarded

Can turn malignant

49
Q

What is the tissue origin for melanotic neuroectodermal tumor of infancy (MNTI)?

A

Neural crest

50
Q

What are the clinical features of melanotic neuroectodermal tumor of infancy?

A

Brown/black lesion in the anterior maxilla

Patients less than 1 year old

51
Q

Which lesion shows radiographically as a radiolucency with maxillary incisor pushed labially appearing as a tooth floating in space?

A

Melanotic neuroectodermal tumor of infancy

52
Q

T/F: Melanotic neuroectodermal tumor of infancy is always benign.

A

False

Can be malignant

53
Q

T/F: 40% of granular cell tumors occur in the tongue.

54
Q

Which lesion has an undetermined histogenesis and is found at birth on maxillary ridge in mostly females?

A

Congenital epulis

55
Q

What is the most common tumor of childhood?

A

Hemangioma (blood)

56
Q

T/F: Most hemangiomas are recognized at birth.

A

False

Most seen by 8 weeks

57
Q

What is the most common intraoral site for hemangioma?

58
Q

T/F: The majority of hemangiomas resolve on their own.

A

True

50% by age 5, 90% by age 9

59
Q

How long should you wait until treating a hemangioma?

A

Until child is 6 years old

Unless life threatening or impairing vision

60
Q

T/F: A vascular malformation is a structural anomaly of blood vessels.

A

True

Normally endothelial cell turnover

61
Q

What are the clinical features of a vascular malformation?

A

Port wine stain (capillaries), venous malformation (blue), arteriovenous malformation (bruit, thrill)

62
Q

T/F: Vascular malformations grow proportionally with patient.

63
Q

What is diascopy?

A

Press on the lesion with glass slide - lesion will blanch as blood is pressed into other tissues

64
Q

T/F: If a lesion blanches with diascopy it is a vascular malformation.

A

False

Other lesions will blanch as well

65
Q

What are some oral considerations with port wine stain?

A
  1. Hemorrhage may be encountered upon flossing and prophy

2. Lasers can help remove hyperplastic lesions

66
Q

T/F: Encephalotrigeminal angiomatosis is an inherited condition.

A

False

Congenital vascular malformation involving CN V

Can cause seizures, IQ disability, migraines, stroke-like episodes

67
Q

Which divisions of CN V are often affected in people with Encephalotrigeminal angiomatosis?

A

Often in V1, can also extend into V2 or V3

If port wine stain involves entire V1, patient at high risk for neurologic and ocular involvement

AU18: Oral Path 2 (18 decks)

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