Benign Soft Tissue Tumors and Vascular Malformations

Question 1

What is a granular cell tumor?

Answer 1

Uncommon benign soft tissue neoplasm

Question 2

What cells are a granular cell tumor derived from?

Answer 2

Derived from Schwann cells or neuroendocrine cells

Question 3

Where are granular cell tumors most common?

Answer 3

Most common in the oral cavity and on the skin

Question 4

What is the single most common site for granular cell tumors?

Answer 4

Tongue which accounts for 1/3 to 1/2 of all reported cases

Question 5

Histopathologic features of granular cell tumor

Answer 5

Large polygonal cells

Abundant pale, eosinophilicm granular cytoplasm

Lesion is not encapsulated and appears to infiltrate the adjacent CT

Positivity for S-100 protein within the cells

Presence of acanthosis and pseudoepitheliomatous hyperplasia of the overlying epithelium

Small vesicular nuclei

Question 6

What condition can granular cell tumor be mistaken for histopathologically?

Answer 6

SCC

Question 7

Tx for granular cell tumors?

Answer 7

conservative surgical excision

Question 8

Recurrence for granular cell tumors?

Answer 8

recurrence is common

Question 9

What is congenital epulis?

Answer 9

Uncommon soft tissue tumor

Question 10

What population does congenital epulis often affect and what part of the body?

Answer 10

Occurs on the alveolar ridges of newborns

Question 11

Clinical appearance of congenital epulis?

Answer 11

Polypoid mass

Question 12

Tx for congenital epulis

Answer 12

surgical excision

Question 13

recurrence for congenital epulis?

Answer 13

lesions have never been reported to recur

Question 14

What is a hemangioma?

Answer 14

Benign tumors of infancy that display a rapid growth phase with endothelial proliferation, followed by gradual involution

Question 15

When does a hemangioma arise?

Answer 15

during the first 8 weeks of life

Question 16

How commin is hemangiona?

Answer 16

most common tumor of infancy

Question 17

What is the most common location on the body for hemangiomas?

Answer 17

head and neck

Question 18

What is the clinical appearance of hemangiomas at birth?

Answer 18

Fully developed hemangiomas are rarely present at birth although a pale macule with threadlike telaniectasias may be noted on the skin

Question 19

How do superficial hemangioma tumors appear?

Answer 19

Superficial tumors appear raised and bosselated with a bright red color (strawberry hemangiomas) that is firm and rubber to palpation

Question 20

How do deeper hemangioma tumors appear?

Answer 20

Deeper tumors may appear only slightly raised with a bluish hue

Question 21

How long is the proliferative phase of hemangiomas?

Answer 21

6-10 months after which the tumor slows in growth and begins to involute and the color changes

Question 22

Histopathologic features of hemangiomas?

Answer 22

Circumscribed cellular mass of vascular endothelial cells arranged in lobular aggregates

Form occasional indistinct vascular lumina

Well formed capillary sized vessels

Question 23

Tx for hemangiomas

Answer 23

watchful neglect because despite rapid growth, regression usually occurs

Surgical resection is rarely warranted

Question 24

What is the self resolution rate of hemangiomas?

Answer 24

50% of all hemangiomas resolve by age 5. 90% resolve by age 9

Question 25

What percentage of hemangioma patients show permanent changes such as atrophy and scarring?

Answer 25

40%

Question 26

What are choristomas?

Answer 26

tumor-like growth of microscopically normal tissue in an abnormal location

Question 27

What are hte most commonly observed choriostomas of the oral cavity?

Answer 27

osseous and cartilaginous choristomas (choristomas that consist of bone, cartilage or both)

Question 28

What site do osseous and cartilaginous choristomas have a predilection for?

Answer 28

osseous and cartilaginous choristomas show a predilection for the tongue (85%)

Question 29

What is the histopathologic appearance of osseous and cartilaginous choristomas?

Answer 29

Mass of dense lamellar bone beneath the surface epithelium

Question 30

Tx for osseous and cartilaginous choristomas

Answer 30

local surgical excision

Question 31

Recurrence of osseous and cartilaginous choristomas?

Answer 31

Recurrence has not been reported