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AU18: Oral Path 2 > Bone Neoplasms (3) > Flashcards

Bone Neoplasms (3) Flashcards

1
Q

List three malignant neoplasms of bone?

A
  1. Chondrosarcoma
  2. Osteosarcoma
  3. Metastatic disease
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2
Q

Which syndrome is associated with central ossifying fibroma?

A

Hyperparathyroidism-jaw tumor syndrome

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3
Q

Which syndrome is associated with an osteoma?

A

Gardner syndrome

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4
Q

Which syndrome is associated with giant cell granuloma?

A
  1. Hyperparathyroidism

2. Renal osteodystrophy

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5
Q

Most authorities consider a central ossifying fibroma to be an _______________.

A

Osteogenic neoplasm

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6
Q

T/F: Central ossifying fibromas are benign tumors that are sometimes seen outside of the jaw.

A

True

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7
Q

Where are central ossifying fibromas often found?

A

Mandibular molar/pre-molar region

Female predilection (3rd-4th decade)

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8
Q

T/F: Jaw expansion and facial asymmetry is possible with central ossifying fibroma.

A

True

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9
Q

T/F: Central ossifying fibroma will show radiographically as completely radiolucent.

A

False

Can be totally radiolucent or have radiopacity within it

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10
Q

What type of tissue is seen in a central ossifying fibroma?

A

Fibrous tissue with mix of bony and cementum like material

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11
Q

What is the treatment and prognosis for central ossifying fibroma?

A

Enucleation as one mass

Excellent

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12
Q

T/F: Tori and exostoses are considered osteomas.

A

False

They are histopathologically identical, but osteomas do not stop growing

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13
Q

T/F: Osteomas can occur on the surface of bone or within the bone.

A

True

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14
Q

Where are the most common places for osteomas?

A

Paranasal sinuses

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15
Q

Where is the most common place to get a gnathic osteoma?

A

Mandibular body and condyle… often see on lingual premolar/molar area

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16
Q

What will an osteoma look like radiographically?

A

Circumscribed radiopaque mass

Those within bone may appear similar to idiopathic osteosclerosis/condensing osteitis

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17
Q

T/F: Osteomas are filled with bone marrow.

A

False

Minimal marrow or trabeculae

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18
Q

What is the treatment/prognosis of osteomas?

A

Nothing… excision if symptomatic

Good, recurrence rare

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19
Q

T/F: Gardner syndrome is autosomal dominant and highly penetrant.

A

True

If you have the mutation, will most likely get the disease

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20
Q

Multiple Epidermoid cysts and osteomas can lead to what possible diagnosis?

A

Gardner syndrome

High risk for intestinal polyps that will transform to adenocarcinoma

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21
Q

What is the prognosis for Gardner syndrome?

A

Guarded

50% Patients develop adenocarcinoma by 30 years old

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22
Q

T/F: Central giant cell granulomas are more common in older patients.

A

False

Mostly females under 30

23
Q

What is the most common location for a central giant cell granuloma?

A

Usually in the anterior mandible crossing the midline

24
Q

T/F: Central giant cell granulomas can break through bone and into soft tissue.

A

True

Typically asymptomatic but can be more aggressive

25
Q

What is the treatment and prognosis for central giant cell granuloma?

A

Aggressive curettage/osteotomy

Good, recurs 15-20% of the time

26
Q

What are the two types of hyperparathyroidism?

A

Primary - parathyroid hyperplasia, parathyroid adenoma or carcinoma -> inappropriate secretion of PTH

Secondary - renal failure -> altered vitamin D -> poor calcium retention

27
Q

T/F: PTH activates osteoblasts.

A

False

PTH activates osteoclasts to break down bone calcium and increase blood calcium

28
Q

What is often seen in dental radiographs of a patient with hyperparathyroidism?

A

Loss of lamina dura and “ground glass” appearence

29
Q

What tumor is associated with Hyperparathyroidism and what is it similar to?

A

Brown tumors

Similar to peripheral giant cell granuloma, CGCG, and giant cell tumor of bone

30
Q

What oral manifestations will be seen with Hyperparathyroidism patients with renal osteodystrophy that may be on dialysis?

A

Prominent enlargement of the jaw(s)

31
Q

What is the treatment/prognosis for hyperparathyroidism?

A

Primary - remove source
Secondary - better control, renal transplant

Fair

32
Q

What is the 2nd most common bone malignancy?

A

Chondrosarcoma

Still rare however

33
Q

Chondrosarcoma is a malignancy of _____________ differentiation.

A

cartilaginous

34
Q

What are the most likely places to see a chondrosarcoma?

A

Femur, pelvis, ribs

35
Q

What percentage of chondrosarcoma are seen in head and neck?

A

10%

36
Q

T/F: Chondrosarcoma in the head and neck can mimic dental infection.

A

True

37
Q

T/F: Chondrosarcoma will present as a well defined radiolucency.

A

False

Poorly defined radiolucency with some radiopacity

38
Q

What is the histopathological features of chondrosarcoma?

A

Invasive lobules of atypical cells with cartilaginous differentiation

39
Q

What is the treatment/prognosis for chondrosarcoma?

A

Radical surgery

Generally poor, depends on location and grade

Metastasis to lung

40
Q

What is the most common primary bone malignancy?

A

Osteosarcoma

41
Q

What percentage of osteosarcoma affect the jaws?

A

8%

42
Q

Where do most osteosarcomas occur?

A

In the long bones at the knee

43
Q

What are the clinical features of an osteosarcoma in the jaws?

A

Swelling, loose teeth, parasthesia

44
Q

T/F: Osteosarcoma in the jaws often shows as a “sun burst” pattern radiographically.

A

False

Less common in the jaw
Will see mixed radiopaque/radiolucent lesion instead

45
Q

What types of cells will be seen in an osteosarcoma?

A

Osteoblastic, chondroblastic, and fibroblastic cells producing osteoid

46
Q

T/F: Radical surgery is the only treatment for osteosarcoma.

A

False

Induction chemotherapy, then surgery to remove tumor

47
Q

What is the prognosis for osteosarcoma?

A

Fair

5 year survival 30-50%

Metastasis to lung

48
Q

What is the most common form of cancer involving the bone?

A

Metastatic disease

49
Q

T/F: Jaws are often affected with metastatic disease.

A

False

1% of all oral malignancies are metastatic disease

50
Q

What is the significance of Batson’s plexus?

A

Valveless vertebral venous plexus allows spread of tumor cells against gravity up to the jaws

51
Q

Which jaw is most commonly affected with metastatic disease?

A

Mandible

52
Q

T/F: Metastatic disease is most commonly seen as a poorly defined radiolucency.

A

True

53
Q

What are the most common metastatic diseases?

A

Breast, lung, colon, thyroid, prostate, kidney, melanoma

54
Q

What is the treatment and prognosis of metastatic disease?

A

Palliative with radiation therapy

Very poor, most die within a year

22% of jaw metastases are initial manifestation

AU18: Oral Path 2 (18 decks)

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