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AU'18 Oral Path II > Bone Neoplasms - part I > Flashcards

Bone Neoplasms - part I Flashcards

1
Q

benign neoplasms of bone

A
  1. central ossifying fibroma
  2. osteoma
  3. central giant cell granuloma
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2
Q

malignant neoplasms of bone

A
  1. chondrosarcoma
  2. osteosarcoma
  3. metastatic disease
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3
Q

what is central ossifying fibroma confused with in the past?

A

focal COD

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4
Q

T/F: most authorities consider central ossifying fibroma to be an osteogenic neoplasm

A

true

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5
Q

T/F: central ossifying fibroma is common

A

false, rare

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6
Q

who is affected by central ossifying fibroma?

A

adult (3rd-4th decade)

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7
Q

T/F: central ossifying fibroma has a female predilection

A

true

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8
Q

where does central ossifying fibroma primarily affect?

A

mandibular molar/pre-molar region

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9
Q

T/F: central ossifying fibroma can be asymptomatic esp when small

A

true

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10
Q

clinical features of central ossifying fibroma

A
  1. may see jaw expansion

2. facial asymmetry to significant deformity

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11
Q

radiographic features of central ossifying fibroma

A
  1. usually unilocular, occasionally multilocular

2. well-circumscribed with varying amount of central opacity

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12
Q

what is the range of radiolucency for central ossifying fibroma?

A

range from almost completely radiolucent to radiodense with a defined lucent border

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13
Q

what does central ossifying fibroma resemble radiographically?

A

focal COD

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14
Q

histopathologic features of central ossifying fibroma

A
  1. fibrous tissue with variable mixture of bony trabeculae and cementum-like material
  2. microscopically similar to fibrous dysplasia
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15
Q

what is needed for the correlation of fibrous dysplasia and central ossifying fibroma?

A

need radiograph

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16
Q

tx of central ossifying fibroma

A

enucleation - lesion tends to shell out as one mass

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17
Q

prognosis of central ossifying fibroma

A

excellent

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18
Q

T/F: recurrence of central ossifying fibroma is common

A

false, uncommon

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19
Q

what can central ossifying fibroma cause?

A

hyperparathyroid-jaw tumor syndrome

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20
Q

hyperparathyroid-jaw tumor syndrome

A
  1. multiple jaw lesions

2. hyperparathyroidism –> hypercalcemia

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21
Q

hyperparathyroid-jaw tumor syndrome lesions are histopathologically consistent with what?

A

central ossifying fibroma

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22
Q

hyperparathyroid-jaw tumor syndrome increases one’s risk for development of what?

A

parathyroid carcinoma

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23
Q

what is NOT considered osteoma?

A
  1. palatal tori
  2. mandibular tori
  3. buccal exostoses
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24
Q

T/F: although palatala tori, mandibular tori and buccal exostoses are not considered osteomas, they are all histopathologically identical

A

true

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25
Q

what is osteoma composed of?

A

compact or cancellous bone

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26
Q

what is osteoma confirmed by?

A

continuous growth

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27
Q

who is affected by osteoma?

A

adult

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28
Q

clinical features of osteoma

A
  1. usually painless, but pain/swelling possible

2. slow growing

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29
Q

where may osteoma arise?

A

on bone surface or within bone (exostosis/enostosis)

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30
Q

T/F: gnathic lesions are more common than paranasal sinus involvement in osteoma

A

false, paranasal sinus involvement more common

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31
Q

where does gnathic osteoma lesions most commonly found?

A
  1. mandibular body
  2. condyle
  3. inferior border of angle
  4. coronoid process
  5. ramus
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32
Q

osteomas on body of mandible is often found where?

A

lingual premolar/molar area

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33
Q

what might condylar involvement for osteoma cause?

A
  1. limit mouth opening
  2. cause malocclusion
  3. deviation of midline
  4. chin to unaffected side
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34
Q

radiographic features of osteoma

A

circumscribed radiopaque mass

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35
Q

how might periosteal (exostoses) osteoma appear on radiographs?

A

may be uniformly sclerotic or have central trabeculations

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36
Q

how might endosteal (endostoses) appear on radiographs?

A

may appear similar/identical to idiopathic osteosclerosis or condensing osteitis

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37
Q

histopathologic features of osteoma

A

dense bone, minimal marrow or trabeculae and fibrofatty marrow

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38
Q

tx of small, asymptomatic osteoma

A

none, observe

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39
Q

tx of osteoma

A

conservative excision

40
Q

T/F: osteoma with condylar involvement is usually symptomatic

41
Q

tx for osteoma with condylar involvement

A

local resection or condylectomy

42
Q

prognosis of osteoma

43
Q

T/F: recurrence of osteoma is common

A

false, rare

44
Q

what should be ruled out if pt presents with multiple osteomas?

A

rule-out Gardner syndrome

45
Q

T/F: Gardner syndrome is common

A

false, uncommon

46
Q

T/F: Garner syndrome is autosomal dominant

A

true, highly penetrant

47
Q

what is the most significant aspect of Garner syndrome?

A

development of precancerous polyps of colon

48
Q

what does Garner syndrome generally refers to?

A

to cases in which the extraintestinal manifestations are especially prominent

49
Q

T/F: Garner syndrome is one of several polyposis syndromes

50
Q

T/F: intestinal polyps due to Garner syndrome are one of the multiple intestinal polyposis syndromes

51
Q

what does Garner syndrome eventually develop to?

A

colorectal polyps develop by 2nd decade, ultimately transform to adenocarcinoma

52
Q

when do multiple osteomas develop?

A

around puberty

53
Q

clinical features of Garner syndrome

A
  1. intestinal polyps
  2. multiple osteomas
  3. epidermoid cysts
  4. desmoid tumors
  5. abnormalities of teeth
54
Q

desmoid tumors

A

locally aggressive fibrous neoplasm of soft tissue

55
Q

abnormalities of teeth seen in pts with Garner syndrome

A
  1. impacted teeth
  2. supernumerary teeth
  3. odontomas
56
Q

what can Garner syndrome resemble radiographically?

A
  1. florid COD

2. fibrous dysplasia

57
Q

size of radioopacities of ppl with Garner syndrome

A

ranging from a few mm to several cm in diameter

58
Q

histopathologic features of Garner syndrome

A

intestinal polyps with varying degrees of dysplasia/adenocarcinoma

59
Q

Garner syndrome histopathologically is consistent with what normal findings?

A
  1. osteoma

2. epidermoid cyst

60
Q

tx of Garner syndrome

A
  1. prophylactic colectomy
  2. removal of cosmetically problematic cysts and osteomas
  3. genetic counseling
61
Q

prognosis of Garner syndrome

62
Q

etiology of central giant cell granuloma (CGCG)

63
Q

who is affected by CGCG?

A

broad age range, most before 30 y.o.

64
Q

what is the gender predilection for CGCG?

A

2:1 female

65
Q

where does CGCG usually occur?

A

mandible, often crosses midline

66
Q

T/F: CGCG is more common in anterior portions of jaw

67
Q

clinical features of CGCG

A
  1. typically asymptomatic
  2. can be expansile
  3. can break through bone and move into soft tissue
68
Q

T/F: some CGCG show locally aggressive behavior

A

true, i.e. root resorption

69
Q

radiographic features of CGCG

A
  1. unilocular/multilocular radiolucency
  2. range in size from a few mm to several cm
  3. well-delineated, generally not corticated
70
Q

histopathologic features of CGCG

A
  1. proliferation of vascular granulation tissue with numerous multinucleated giant cells and extravasated erythrocytes
71
Q

CGCG has the same histologic appearance as what?

A
  1. brown tumor of hyperparathyroidism
  2. peripheral giant cell granuloma
  3. giant cell tumor of bone
72
Q

T/F: need radiographic correlation and blood test for parathormone (PTH) in CGCG

73
Q

tx of CGCG

A

aggressive curettage/peripheral osteotomy

74
Q

what should be ruled out before tx of CGCG?

A

hyperparathyroidism

75
Q

prognosis of CGCG

76
Q

2 types of hyperparathyroidism

A
  1. primary

2. secondary

77
Q

primary hyperparathyroidism

A

inappropriate secretion of PTH

78
Q

what may cause primary hyperparathyroidism?

A
  1. parathyroid hyperplasia
  2. parathyroid adenoma
  3. carcinoma
79
Q

secondary hyperparathyroidism

A

renal failure –> altered vitamin D metabolism –> poor calcium retention

80
Q

what are the actions of PTH?

A
  1. osteoclastic activation
  2. increased Ca2+ uptake by kidneys
  3. increase vitamin D synthesis (kidneys) which promotes Ca2+ from the gut
81
Q

inappropriate secretion of PTH in primary hyperparathyroidism causes what?

A

increased serum Ca2+

82
Q

kidney failure –> inadequate producation of vitamin D which is needed to absorb calcium from the gut causes what in secondary hyperparathyroidism?

A

increased serum Ca2+

83
Q

clinical features of hyperparathyrodism

A

“bones, stones, groans and moans” (thrones)

84
Q

radiographic features of hyperparathyroidism

A
  1. loss of lamina dura
  2. “ground glass” trabecular pattern
  3. unilocular/multilocular radiolucency
85
Q

what might the radiolucencies in ppl with hyperparathyroidism resemble radiographically?

A
  1. brown tumor of hyperparathyroidism

2. renal osteodystrophy

86
Q

renal osteodystrophy

A

enlargement of jaws due to long-standing renal failure

87
Q

histopathologic features of ppl with hyperparathyroidism

A

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

88
Q

what does hyperparathyroidism microscopically the same as?

A
  1. peripheral giant cell granuloma
  2. CGCG
  3. giant cell tumor of bone
89
Q

renal osteodystrophy due to hyperparathyroidism

A

unusual hyperplastic response of bone in patients with poorly controlled secondary hyperparathyroidism

90
Q

renal osteodystrophy due to hyperparathyroidism is seen in what type of patients?

A

patients on long-term renal dialysis

91
Q

T/F: renal osteodystrophy due to hyperparathyroidism may manifest as prominent jaw enlargement

92
Q

tx of primary hyperparathyroidism

A

remove parathyroid

93
Q

tx of secondary hyperparathyroidism

A

better control of serum calcium

94
Q

what may be needed to tx secondary hyperparathyroidism?

A
  1. parathyroidectomy may be needed

2. renal transplant

95
Q

prognosis of hyperparathyroidism

96
Q

what is prognosis of hyperparathyroidism associated with?

AU'18 Oral Path II (31 decks)

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