Benign Soft Tissue Flashcards
Fibroma is reactive or neoplastic?
Reactive to local trauma/irritation
Most common tumor of oral cavity?
Fibroma
Fibroma is true neoplasm?
no
Histology of fibroma?
unencapsulated, collagenized CT covered by SSE
Treatment of fibroma?
excision to r/o neoplasm
Recurrence common or rare in fibroma?
rare
Fibroma clinical features:
Pigment:
Surface texture:
Sessile/pedunculated?
Normal color (can be white from hyperkeratosis)
Smooth
Sessile
Fibromas can be found where in oral cavity?
anywhere
Giant cell fibroma important histo feature?
Stellate fibroblasts with several nuclei
Variant of giant cell fibroma?
Retrocuspid papilla
Retrocuspid papilla location?
bilateral, lingual to mand. canines
Pyogenic granuloma aka?
Lobular capillary hemangioma, pregnancy tumor
Pyogenic granuloma bad name bc?
neither pyogenic or granuloma
Pyogenic granuloma clinical features? Surface texture color Pedunc or sessile Pain Blood
Smooth/lobulated
Pedunculated/sessile
Pink/red/purple, ulcerated
Bleeds easily
Pyogenic granuloma new vs old difference
Vascular when new, collagenized when old
Pyogenic granuloma location?
80% gingiva
Variant of pyogenic granuloma arising in healing extraction socket?
Due to what?
epulis granulomatosa due to bony sequestra in socket
Pyogenic granuloma histopath features
vascular granulation tissue
Pyogenic granuloma treatment
excise and remove irritants
Pyogenic granuloma distinguished how from retrocuspid papilla?
Pyogenic granuloma is erythematous or hemorrhagic while retrocuspid papilla is pink, small, and bilateral.
Peripheral giant cell granuloma soft tissue counterpart to what?
Central giant cell granuloma
Peripheral giant cell granuloma occurs where
Gingiva ONLY
Peripheral giant cell granuloma differs from pyogenic granuloma how?
more blue-purple, otherwise similar
Radio features of Peripheral giant cell granuloma?
cupping resorption of bone
Peripheral giant cell granuloma origin might be soft or hard tissue, need to workup patient for what?
Hyperparathydoidism
Peripheral giant cell granuloma histopath features (cells, deposits, and surface)
multinucleated giant cells with background of mesenchymal cells with mitoses, hemorrhage and hemosiderin, ulcerated mucosa overlying
Peripheral Ossifying Fibroma occurs where
Gingiva ONLY
Peripheral Ossifying Fibroma clinical features Surface Color Type What can happen to teeth
ulcerated, red-pink, Ped/Sess nodule, rare migration and loosening of teeth
Peripheral Ossifying Fibroma histopath features
fibrous, mineralized product
Peripheral Ossifying Fibroma can be easily mistaken for?
Pyogenic granuloma
Lipoma usually occurs where
trunk or extremities, rarely in oral cavity
What is #1 most common mesenchymal neoplasm?
Lipoma
Lipoma clinical features?
soft, smooth, pink/yellow
Granular cell tumor found where
Oral cavity, usually tongue
Granular cell tumor color
pink or yellow
Granular cell tumor cell differentiation
neural
Granular cell tumor histopath features
pale, eosinophilic granular cytoplasm
pseudoepitheliomatous hyperplasia
Congenital Epulis occurrence/age//location?
rare, newborns, alveolar ridge
Congenital Epulis resembles?
Granular cell tumor
Congenital Epulis gender predilection %
90% female
Congenital Epulis histopath features similar to ? Exception?
Similar to granular cell tumor (abundant pale eosinophilic granular cytoplasm) but NO pseudoepitheliomatous hyperplasia
Most common peripheral nerve tumor?
Neurofibroma
Neurofibroma differentiation/histopath?
schwann/perineural cells, wavy nuclei, mast cells
Neurofibromatosis how many forms? Most common?
8, Type 1 most common (90%)
Neurofibromatosis causes what disease? Genetic source?
von Reck, autosomal dominant chromosome 17
Neurofibromatosis clinical features
multiple neurofibromas on skin, oral
Cafe au lait pigmentation - smooth macules
Crowe sign - freckles on axilla
Lisch Nodules - brown pigmentation on iris
Oral manifestation of Neurofibromatosis?
50% enlarged fungiform papillae
Schwannoma most common oral site?
tongue
Schwannoma histopath features
encapsulated tumor
Schwannoma 2 patterns?
Antoni Pattern A - streaming fascicles of spindle Schwann cells palisaded around acellular Veroclay bodies
Antoni Pattern B - random spindle cells in loose myxomatous stroma
Traumatic Neuroma happens why
transection or damage of nerve bundle leads to proliferation of neural tissue
Multiple Endocrine Neoplasia - genetic passing?
autosomal dominant
MEN Type 2 - three subtypes
Familial medullary thyroid carcinoma syndrome
MEN Type 2A
MEN Type 2B
MEN Type 2A - conditions (3)
Medullary carcinoma of thyroid (MCT) 95%
pheochromocytoma of adrenal medulla 50%
parathyroid hyperplasia/adenoma 25%
MEN Type 2B - How related to type 2A?
same conditions + multiple mucosal neuromas
MEN Type 2B clinical features?
Mucosal neuromas on eyes
Oral neuromas - painless papules on lips and anterior tongue.
MCT - ALMOST ALL PATIETNS, aggressive and metastatic, requires prophylactic thyroidectomy before age 1
MEN Type 2B first sign of disease?
Oral neuromas
MCT lab values
elevated serum/urinary calcitonin
pheochyromocytomas lab values
urinary vanillylmandelic acid (VMA) and increase epi to norepi ratio
Most common tumor of children
hemangioma of infancy
Evolution of hemangioma of infancy?
proliferate 6-10 months before involution
Vascular malformations happen when?
present at birth, persist
Lymphatic malformation most common site?
Surface?
65% in head/neck region
Most common on anterior tongue
Pebbly
Lymphatic malformation histopath?
proliferation of lymphatic vessels, valves