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Oral Path 3 > Bone neoplasms > Flashcards

Bone neoplasms Flashcards

1
Q

Central Ossifying Fibroma comes from where

A

PDL firbroblast

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2
Q

Central Ossifying Fibroma confused with what in the past

A

focal cementosseos dysplasia

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3
Q

Central Ossifying Fibroma found in which region and in who?

A

30-40s adult females

molar premolar region

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4
Q

Central Ossifying Fibroma radiographic characteristics

A

well circumscribed radiolucency with central opacity

can range from mostly radiolucent and radiodense in the middle

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5
Q

Central Ossifying Fibroma clinical appearance

A

asymmpotmatic swelling
facial deformation
root divergence

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6
Q

Central Ossifying Fibroma biopsy

A

seperates from host bone easily in one piece.

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7
Q

Central Ossifying Fibroma histology

A

Cellular fibrous connective tissue with calcified trabeculae/spherules resembling cellular cementum or woven bone
Similar histology to fibrous dysplasia

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8
Q

Central Ossifying Fibrom trt

A

enucleation

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9
Q

Central Ossifying Fibrom prognosis

A

very good, low recurrence

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10
Q

Osteoma histology

A

normal bone with or without marrow

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11
Q

Osteoma what is it and where

A

benign osseous tumor
primary craniofacial bones (paranasal sinus)
and mandible (body and condylar region)

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12
Q

Osteoma clinical

A

painless, slow growing

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13
Q

Gardner Syndrome what kind of diseas

A

genetic
1:8,000- 1:16,000 births
APC gene, chromosome 5

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14
Q

Gardner Syndrome main characteristics

A

multiple osteomas of the facial bones.
epidermoid cysts
desmoid tumors

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15
Q

Gardner Syndrome teeth problems

A

may see impacted supernumeray teeth

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16
Q

Gardner Syndrome radiographically

A

may resemble florid cemento- osseous dysplasia or osteitis deformans

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17
Q

Gardner Syndrome most significant aspect of the syndrome

A

development of precancerous polyps of the colon

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18
Q

Gardner Syndrome precancerous poly problems…

A

50% of patients develop adenocarcinoma of the colon by 30 years of age (approaches 100% by 5th decade)

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19
Q

Gardner Syndrome management

A

– Prophylactic colectomy
– Removal of problematic cysts and osteomas
– Removal of impacted teeth/odontomas with prosthodontic work as needed
– Genetic counseling


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20
Q

Central Giant Cell Granuloma

A

benign lesion of the jaw,
neoplasm or reactive process???
(use to be called reactive giant cell)

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21
Q

Central Giant Cell Granuloma affects who most

A

60% under 30 years old

female

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22
Q

Central Giant Cell Granuloma found where

A

mandible (70%), anterior, can cross midline

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23
Q

Central Giant Cell Granuloma radiographically

A

unilocular when small, multilocular when larger. LARGE radiolucency

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24
Q

Central Giant Cell Granuloma histo

A

cellular granulation tissue with numerous benign multinucleated giant cells
RBC extravasation and hemosiderin deposits are common

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25
Q

Central Giant Cell Granuloma trt

A

generally consists of aggressive curettage, although alternative non- surgical therapies have been reported

26
Q

Central Giant Cell Granuloma prognosis

A

good

27
Q

Central Giant Cell Granuloma recurrence

A

20%

28
Q

Hyperparathyroidism primary vs secondary

A

primary-due to parathyroid hyperplasia, parathyroid adenoma, parathyroid carcinoma
secondary- due to renal failure, which is responsible for poor calcium retention and altered vitamin D metabolism

29
Q

Hyperparathyroidism bone lesions

A

Unilocular/multilocular radiolucencies may develop - “brown tumor”
Diffuse jaw enlargement may develop with chronic renal failure: renal osteodystrophy

30
Q

Hyperparathyroidism bone lesion radiographically

A

loss of lamina dura and “ground-glass” trabecular pattern

31
Q

Hyperparathyroidism histo

A

brown tumors show vascular granulation tissue with numerous multinucleated giant cells and extravasated erythrocytes

32
Q

Hyperparathyroidism looks similar to what in microscope

A

Microscopically identical to central giant cell granuloma

33
Q

Renal Osteodystrophy

A

Hyperplastic response of the bone in patients with poorly-controlled secondary hyperparathyroidism related to end-stage renal disease
Prominent jaw enlargement may result

34
Q

Hyperparathyroidism trt

A

If primary, remove the source of excess hormone secretion
– If secondary, better control of serum calcium levels. Parathyroidectomy may be needed if medical therapy fails. Renal transplant is another alternative

35
Q

Hyperparathyroidism prognosis

A

fair to good

36
Q

Osteosarcoma

A

Most common primary bone malignancy

tumor cells produce osteoid

37
Q

Osteosarcoma, how many affect the jaw

A

6-8%

38
Q

Osteosarcoma who

A

second decade
long bones- mean age 18
Jaws- 33-39

39
Q

Osteosarcoma clinical appearance

A

pain, swelling, paresthesia, loose teeth

40
Q

Osteosarcoma radiographically

A

mixed radiopaque and radiolucency with ill defined borders
Widen PDL
Sun Burst pattern is uncommon in the jaws

41
Q

Osteosarcoma histo

A

Infiltrating sheets of malignant spindle-shaped or angular lesional cells
Direct production of osteoid or bone Mitotic activity can vary from field to field
Osteoblastic, chondroblastic and fibroblastic differentiation may be seen

42
Q

Osteosarcoma trt

A

is radical surgery, together with chemotherapy is some cases

43
Q

Osteosarcoma prognosis

A

Overall 5 yr survival: 60-70%

death usually due to uncontrolled local disease than metastasis

44
Q

Chondrosarcoma

A

Rare malignancy of cartilaginous differentiation (1/2 as common as osteosarc)
pain, swelling, loose teeth

45
Q

Chondrosarcoma seen in who and where?

A 
adult males 4th 6th decade of life
femur, pelvis, or ribs mostly
.1% of all head and neck malignancies
anterior maxilla 
posterior mandible
46
Q

Chondrosarcoma radiographic

A

Poorly defined radiolucency with variable amounts of radiopacity
Larger lesions may appear multilocular
May see widened PDL of the teeth in the area of the tumor, similar to osteosarcoma

47
Q

Chondrosarcoma histo

A

characterized by invasive lobules of atypical cells showing cartilaginous differentiation
most jaw lesions are grade 1 or 2

48
Q

Chondrosarcoma trt

A

radical surgery

49
Q

Chondrosarcoma prognosis

A

depends on histo grade and location of tumor

50
Q

Chondrosarcoma survival

A

5 and 10 yr survival: 87% and 71% respectively

death usually due to direct extension of the tumor into vital structures.

51
Q

Metastatic Disease

A

Most common form of cancer to involve bone

sometimes Jaws are affected.

52
Q

Metastatic deposits from malignancies below the neck may affect the jaws through

A

Batson’s paravertebral plexus of veins which lack valves

53
Q

Metastatic Disease who and where

A

43-52 years old.

posterior mandible.

54
Q

Metastatic Disease clinical characteristics

A
  • paresthesia, tooth mobility, swelling, bleeding, trismus, fracture
  • failure of tooth socket to heal.
55
Q

Metastatic Disease radiology

A

Poorly defined radiolucency; less commonly, mixed radioluceny/radiopacity

56
Q

Metastatic Disease histo what do the mimic

A

the primary malignancy from which they arose

57
Q

Metastatic Disease scattered cluster of

A

lesional cells give a “seeded” effect

58
Q

Metastatic Disease primary malignancy arise from where

A

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

59
Q

_____% of jaw metastases represent the initial manifestation of the malignant process

A

22%

60
Q

Metastatic Disease trt

A

palliation, usually with radiation therapy, anti-resorptives

61
Q

Metastatic Disease prognosis

A

very poor, most die within a year

Oral Path 3 (3 decks)

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