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Oral Pathology > Ch 15 Odontogenic cysts and tumors > Flashcards

Ch 15 Odontogenic cysts and tumors Flashcards

1
Q

which odontogenic tumor contains no calcified structures and therefore is always radiolucent

A

ameloblastoma

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2
Q
  • develops from separation of follicle around a crown
  • usually develop before 35
  • well defined around the crown of impacted tooth
  • usually asymptomatic/non-inflammatory
  • histo: SSE without inflammation
A

dentigerous cyst

  • txt: curettage of cyst with or without extraction of impacted tooth
  • large DC may be txt by marsupialization (creating a window)/decompression
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3
Q
  • soft tissue analogue of dentigerous cyst
  • separation of the dental follicle around the crown of a developing tooth
  • within the soft tissue overlying alveolar bone
  • usually in children younger than 10
  • can come from surface trauma (eruption hematoma)
A

eruption cyst

-txt may not be required due to spontaneous rupture, or simple excision of roof of cyst if does not erupt

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4
Q
  • arises from rests of dental lamina
  • affects males more than females
  • grow within medullary bone without expansion
  • 60-80% mandible
A

odontogenic keratocyst

-txt: enucleation and curettage, peripheral ostectomy, chemical cauterization after cyst removal, DECOMPRESSION

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5
Q
  • multiple basal cell carcinomas
  • odontogenic keratocysts
  • rib and vertebral anomalies (bifid rib)
  • intracranial calcifications
  • palmar and plantar pits
A

basal cell carcinoma syndrome

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6
Q
  • small superficial keratin-filled custs on alveolar mucosa of infants
  • arise from remnants of dental lamina
  • common in 1/2 of newborns and disappear spontaneously by rupture into oral cavity
  • epstein pearls and Bohn’s nodules midline of palate or laterally on hard or soft palate
A

gingival cyst of the newborn

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7
Q
  • soft tissue counterpart of Lateral Periodontal Cyst
  • facial gingival
  • bluish
  • 75-80% mandible canine/premolar region
A

Gingival cyst

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8
Q
  • derived from dental lamina (rests of Serres)
  • Adults in 5-6th decades; rare before 30
  • most cysts less than 1 cm
  • histo shows little “pouches”
A

gingival cyst of the adult

-not really that dangerous, can be removed

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9
Q
  • arise from rests of dental lamina or proliferation of REE along lateral root
  • 2% of epithelial lined jaw cysts
  • affects males >30
  • mandibular canine/premolar region, less common maxillary but same location
  • cuboidal epithelial cells with foci of glycogen rich cells
  • thickening of epithelial lining
A

lateral periodontal cyst

-the histo also has the out “pouches” that the gingival cyst of the adult has

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10
Q
  • gorlin cyst
  • dentinogenic ghost cell tumor
  • calcifying ghost cell odontogenic cyst
  • considered a cyst by some feel neoplas
  • predomintly intraosseous lesion but 13-30% extraosseous
  • mand=maxilla
  • 65% cases found in incisor canine region
  • RL lesion associated with unerupted tooth, most often canine
  • root resorption or divergence of adjacent teeth seen
  • can resemble gingival fibromas, cysts…
A

calcfying odontogenic cyst

-txt: simple enucleation with few recurrences

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11
Q
  • Inflammatory Odontogenic Cyst on the buccal aspect of the mandibular first permanent molar
  • also called Paradental cyst
  • typically occurs in children 5-11
  • foul tasting dischard
  • Xray show well-circuscribed unilocular RL involving buccal furcation and root area
A

Buccal bifurcation cyst

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12
Q

types of Odontogenic tumors

A

Ameloblastoma

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13
Q
  • most common clinically significant odontogenic tumor
  • origins: cell rests of dental lamina, developing enamel organ, lining of odontogenic cyst, basal cells of oral mucosa
  • painless swelling or expansion of jaw
  • pain and paresthesia uncommon even in large tumors
  • ML RL lesions
  • “soap bubble” when large and “honeycombed” when small
  • buccal and lingual cortical expansion and resorption of roots common
  • unerupted tooth (mand 3rd) commonly associated with RL defect
  • a single layer of tall ameloblast-like cells surround central core with reverse polarity
A

ameloblastoma

-tumor islands are as much as 1 cm further than the radiographic features show

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14
Q

Histology:

  • A single layer of tall ameloblast- like cells surround central core with reverse polarity
  • Islands of epithelium resemble enamel organ, consisting of loosely arrnaged angular cells resembling stellate reticulum
  • Plexiform pattern
    • -Long anastomosing cords or larger sheets of odontogenic epithelium
A

ameloblastoma

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15
Q

-grows intramular, similarto ameloblastoma

A

unicystic ameloblastoma

-excise them

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16
Q

-ameloblastoma on posterior gingiva and aleolar mucosa

A

peripheral ameloblastoma

-surgical excision

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17
Q
  • 3-7% odontogenic temors
  • slow growth and circumscription of lesion
  • from enamel organ or remnants of dental lamina
  • epithelial tumor with inductive (calcification)effect on odontogenic ectomesenchyme
  • younger patients (2/3 10-19)
  • anterior portions of jaws; 2X maxilla
  • FEMALE 2X males
  • enucleation
  • often contains “snowflake calcifications”
  • involves crown of unerupted tooth, usually canine
  • extends apically along root past CEJ (distinguis from dent cyst
A

adenomatoid odontogenic tumor

-txt is enucleation

18
Q
  • small foci of calcifications
  • rosettelike structures about central space and may contain eosinophilic materia
  • epithelial cells that form sheets, stands or whorled masses of cells in scant fibrous stroma
A

adenomatoid odontogenic tumor

19
Q
  • also known as Pindborg Tumor
  • rare; 30-50; 2/3 mandible, most often posterior region
  • painless slow growing swelling
  • unilocular or multilocular RL defect which may contain calcified structures
  • frequently associated with impacted mand 3rd molars
A

Calcifying epithelial odontogenic tumor

-txt local resection lesion of posterior maxilla txt more aggressively

20
Q
  • polyhedral epithelial cells in a fibrous stroma
  • epithelial cells distinct with intercellular bridges notes
  • nuclei show considerable variation and can be bizarre
  • calcification distinctive feature develop within the amyloid-like material and form concentric rings (Liesegang ring calcifications)
A

Calcifying Epithelial Odontogenic Tumor

21
Q
  • True mixed tumor of epithelial and mesenchymal elements
  • Younger patients with posterior mandible most common site (70% cases)
  • Unilocular or multilocular RL lesion; xray margins well defined and may be sclerotic
  • Unerupted tooth associated 75%
A

Ameloblastic Fibroma

-txt: conservative removal

22
Q
  • Ameloblastic Fibroma with enamel and dentin
  • average age 10; rare in adults
  • asymptomatic and discovered on xray that is taken for failure of tooth to erupt
A

ameloblastic fibro-odontoma

-txt: conservative curettage and lesion separates easily from bone

23
Q
  • most common odontogenic tumor (not a true tumor)
  • M=F; Max>mand
  • mean age 14 (detected in first 2 decades)
  • compound=complex
  • 48% associated with impacted tooth
  • ALWAYS radio opaque foci density of enamel
  • well defined
  • appears as little tooth masses to globs
A

Odontoma

-txt: remove if blocking tooth eruption

24
Q
  • young adults 25-30 yr olds
  • UL or ML RL that may displace or cause resorption of teeth
  • margins of RL often irregular or scalloped
  • may be “soap bubble”
  • may contain thin wispy trabeculae of residual bone which are arranged at right angles to each other
A

Odontogenic Myxoma

  • txt small myomas managed by curettage with recall of at least 5 yrs
  • larger lesions, resection may be required
25
Q

-neuroectoderm is induced by dental lamina to become specialized cells capable of being induced further into odontogenic cells which differentiate and produce calcified dental tissues

A

odontogenic Ectomesenchyme

26
Q

***histology of odontogenic keratoocyst

A

1-uniformly thin (about 6 layers)
2- devoid of rete pegs
3-prominent basal cell layer
-it can be line with parakeratin (has nuclei) or orthokeratin (without nuclei)

27
Q

***Histo: ghost cells which are altered epithelial cells characterized by loss of nuclei with perservation of cell outline

A

Calcifying Odontogenic Cyst

28
Q
  • **Histo:follicular pattern: single layer of tall ameloblast-like cells surround central core with reverse polarity
  • and plexiform pattern
A

Ameloblastoma (it is trying to do what a tooth does)

29
Q

if you see expansion…

A

probably ameloblastoma

30
Q

which tumor has a stronger predillection for the maxilla?

A

Adenomatorid odontogenic tumor

  • anterior maxilla, usually canine area,
  • “snowflake calcifications”
  • young females
  • it’s benign,
  • txt: surgical excision
31
Q

Liesegang ring calcifications, polyhedral

A

Calcifying Epithelial Odontogenic Tumor

32
Q

basal cell carcinoma syndrome

A
  • multiple basal cell carcinomas
  • odontogenic keratocysts
  • rib and vertebral anomalies (bifid rib)
  • intracranial calcifications
  • palmar and plantar pits
33
Q

bohns nodules and epstein pearls

-what does it come from?

A

gingival cyst of the newborn

-remnants of dental lamina

34
Q

what is the soft tissue counterpart of the lateral periodontal cyst?
-and where does it occur most commonly?

A

gingival cyst

-75-80 Mandibular near PM/K area

35
Q

what abnormalities develop from the dental lamina?

A
  • OKC
  • gingival cyst of newborn
  • gingival cyst of adult
  • lateral periodontal cyst (or REE)
  • Ameloblastoma (one possible origin)
  • Adenomatoid Odontogenic tumor (or from enamel organ)
36
Q

lateral periodontal cyst with multiple compartments

A

Botryoid odontogenic cyst

37
Q

Cuboidal epithelial cells with foci of glycogen rich cells

A

lateral periodontal cyst

38
Q

gorlin cyst

A

calcifying odontogenic cyst

39
Q

ghost cell tumor

A

calcifying odontogenic cyst

40
Q

average age is 10, more rare in adults

-asymptomatic and discovered on wray that is taken for failure of a tooth to erupt

A

ameloblastic fibro-odontoma

41
Q

most common odontogenic tumor (not a true tumor)

-has the density of enamel

A

odontoma

  • txt remove if it is blocking eruption
  • compound is multiple little teeth, complex is enamel, dentin and pulp tissue swirled together
42
Q
  • during surgical excision=gelatinous
  • young adults 25-30
  • mandible>maxilla
  • may be “soup bubble”
A

odontogenic myxoma

Oral Pathology (16 decks)

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