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Neville and Damm > Ch12 Soft Tissue Tumors II -3Ps > Flashcards

Ch12 Soft Tissue Tumors II -3Ps Flashcards

1
Q

_________: an exuberant tissue response to local irritation or trauma

A

Pyogenic granuloma (not cause by pyogenic organisms, nor is it a granuloma lol)

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2
Q

What are three alternate names for pyogenic granuloma?

A

Lobular Capillary Hemangioma…pregnancy tumor…granuloma gravidarum

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3
Q

Young _________ are highly vascular in appearance; older lesions tend to become more collagenized and pink…

A

pyogenic granulomas

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4
Q

Oral PGs: 75%-85% on what surface? What are the 3 other sites?

A

gingiva…lips, tongue,buccal mucosa

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5
Q

PG’s most common sites? Age?

A

maxillary anterior facial gingiva…children, young adults

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6
Q

PG: gender preference? What hormones are blamed?

A

female…increase in estrogen and progesterone in pregnancy

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7
Q

What happens to a PG that developed in pregnancy and was left intact?

A

regresses or becomes a fibroma

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8
Q

___________ is a term used to describe hyperplastic growths of granulation tissue (in healing ext sockets)…thus resembling a PG

A

Epulis granulomatosa

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9
Q

For gingival PGs, the excision should extend down to periosteum and the adjacent teeth should be thoroughly scaled to remove any source of continuing irritation….A recurrence rate of __% to __% has been reported in most studies.

A

3-15%

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10
Q

What is the treatment of a PG during pregnancy?

A

For lesions that develop during pregnancy, usually treatment should be deferred unless significant functional or aesthetic problems develop.

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11
Q

The recurrence rate is higher for __________ removed during pregnancy, and some lesions will resolve spontaneously after parturition.

A

pyogenic granulomas

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12
Q

What is the alternate name for Peripheral Giant Cell Granuloma (PGCG)?

A

Giant Cell Epulis

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13
Q

PGCG probably does not represent a true neoplasm but rather is a _______ lesion

A

reactive….caused by local irritation or trauma.

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14
Q

What are the two theories for the presence of Giant Cells in a PGCG?

A

1.osteoclasts 2.mononuclear phagocytes

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15
Q

What is the ONLY location for a PGCG?

A

gingiva or edentulous alveolar ridge

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16
Q

The peripheral giant cell granuloma often is more _____-_____ colored compared with the bright ____ of a typical pyogenic granuloma.

A

blue-purple…red

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17
Q

PGCG mean age range? Gender? location?

A

31-46 years…52-60% cases female..favor mandible, no anterior/post preference

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18
Q

If you see “CUPPING” of the underlying bone…you can favor which lesion?

A

PGCG (cupping = resorption of the underlying bone)

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19
Q

Dont be alarmed in a PGCG…________ are fairly common in the background mesenchymal cells

A

Mitotic figures

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20
Q

What lesion can have abundant hemorrhage is characteristically found throughout the mass, which often results in deposits of hemosiderin pigment, especially at the PERIPHERY of the lesion?

A

PGCG

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21
Q

PGCG: do they have bone formation?

A

they can have bone formation…or calcifications..fair game

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22
Q

What is the recurrence rate (range) for PGCG?

A

10-18%

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23
Q

Can you have a peripheral browns tumor (hyperparathyroidism)?

A

YEP. Much more likely to be intraosseous, but can be peripheral

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24
Q

What are three alternate names for peripheral ossifying fibroma? (POF)

A

Ossifying fibrous epulis, peripheral fibroma with calcification, calcifying fibroblastic granuloma

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25
Q

The peripheral ossifying fibroma is a relatively common

gingival growth that is considered to be ______ rather than ______ in nature.

A

reactive…neoplastic

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26
Q

The mineralized product probably has its origin from cells of the ______ or _______.

A

periosteum or periodontal ligament

27
Q

The peripheral ossifying fibroma does not represent the soft tissue counterpart of _______

A

the central ossifying fibroma (total BS man)

28
Q

POFs occur EXCLUSIVELY where?

A

on the gingiva

29
Q

POF: age range? gender? location?

A

10-19 (young and young adults)…females(2/3)..maxillary incisor-canine region

30
Q

What lesion am I? a fibrous proliferation associated with the formation of a mineralized product

A

Peripheral Ossifying Fibroma

31
Q

What are the three types of hard tissue found in Peripheral Ossifying Fibromas?

A

bone, cementum-like material, or dystrophic calcifications.

32
Q

When bone is formed in a Peripheral Ossifying Fibroma, what type is seen most often?

A

immature woven/trabecular…less often its mature lamellar

33
Q

If you were to see dystrophic calcifications in a Peripheral Ossifying Fibroma, what does that say about its age?

A

its an early, ulcerated lesion (later progression usually forms mature bone or cementum)

34
Q

What is important for the excision of a Peripheral Ossifying Fibroma? What is the range of recurrence for these?

A

Excise from the periosteum (increased recurrence if not completely excised)…8-16% recurrence rate

35
Q

What is the most common mesenchymal neoplasm? (in the body)

A

Lipoma!

36
Q

What % of lipomas are found in the oral and maxillofacial region?

A

only 1-4% of all body lipomas

37
Q

Lipomas are more common in what demographic?

A

obese people (although the metabolism is separate - you can’t lose weight and then shirnk your lipoma)

38
Q

What color is a lipoma clinically? What about deeper in the lesion?

A

yellow on the surface clinically, pink deeper

39
Q

What are the two most common oral sites for a lipoma?

A

buccal mucosa and vestibule. 50% of cases

40
Q

When a lipoma is found on the buccal mucosa, its either a true lipoma or what may have happened?

A

herneation of the buccal fat pad through the buccinator s/p trauma

41
Q

What are the 3 other sites for a lipoma beside the buccal mucosa/vestibule? Age range? gender?

A

tongue, floor of mouth, and lips…40 years or older…no gender predilection

42
Q

Rarely what two types of metaplasia can occur in an otherwise normal lipoma? (NOT a variant of the lipoma)

A

osseous or cartilagenous metaplasia

43
Q

What is the most common VARIANT of lipoma? what are the 6 other not-as-common variants of lipomas?

A

Most common: fibrolipoma…angiolipoma…spindle cell lipoma..myxoid lipoma..pleomorphic lipomas…intramuscular lipomas…sialolipoma

44
Q

What type of lipomas are characterized by the presence of spindle cells plus bizarre, hyperchromatic giant cells?

A

Pleomorphic lipomas

45
Q

What is the recurrence for a lipoma? Which type of lipoma is most likely to recur?

A

rare. no difference..except for intramuscular lipomas, but they are rare in the oral cavity

46
Q

What is the alternate name for a traumatic neuroma?

A

amputation neuroma

47
Q

Mechanism of a traumatic neruoma: After a nerve has been damaged or severed, the proximal portion attempts to regenerate and reestablish innervation of the distal segment by the growth of axons through tubes of proliferating ______cells.

A

schwann

48
Q

What are the three most common sites for traumatic neuroma?

A

mental foramen area, tongue, lower lip

49
Q

it has been estimated that traumatic neuromas of the _________ nerve develop in 5% to 10% of patients undergoing surgery for pleomorphic adenomas of the parotid gland.

A

greater auricular

50
Q

traumatic neuromas are most often diagnosed in what age group? gender?

A

middle aged adults…female

51
Q

What are the three symptoms typically associated with traumatic neuromas?

A

anesthesia, dysthesia, pain

52
Q

What % range of traumatic neuromas are painful?

A

25-33%

53
Q

Clincal-histological correllation: Traumatic
neuromas with ___________ are more likely to be
painful than those without it.

A

inflammation

54
Q

What is the recurrence rate for Traumatic

neuromas?

A

“most lesions do not recur”…pain can persist or return

55
Q

What is the alternate name for a PALISADED ENCAPSULATED NEUROMA? WHY did it get the alternate name?

A

Solitary Circumscribed Neuroma (I love pathology)…its not always encapsulated and the cells are not usually truely palisaded

56
Q

Most likely origin for Palisaded Encapsulated Neuroma?

A

Likely trauma.. thought to be more reactive than a true neoplasm

57
Q

What % of Palisaded Encapsulated Neuromas are in the face? What are the 2 most common sites on the face? Age range?

A

90%..nose and cheek…50-60’s

58
Q

What are the 3 most common sites of Palisaded Encapsulated Neuromas in the oral cavity? They are common, but have probably been diagnosed as what two lesions in the past?

A

hard palate, gingiva, labial mucosa……schwannomas or neurofibromas

59
Q

Palisaded Encapsulated Neuromas consist of moderately cellular interlacing fascicles of spindle cells that are consistent with _______ cells

A

Schwann

60
Q

Palisaded Encapsulated Neuromas stain positive for _____ and NEGATIVE for ______ (helping to exclude other neural tumors)

A

S100…negative GFAP (GFAP + CNS tumors)

61
Q

What is the recurrence for Palisaded Encapsulated Neuromas?

A

rare

62
Q

What two important entities are RULED OUT by a diagnosis of Palisaded Encapsulated Neuroma?

A

Neurofibromatosis and MEN 2B (NO association with Palisaded Encapsulated Neuromas and these entities)

63
Q

What are the two alternate names for PGs that develop on the gingiva during pregnancy?

A

pregnancy tumor or granuloma gravidarum

64
Q

If a PG on the gingiva develops during pregnancy, what term do they usually begin? How long does their prevalence increase?

A

1st trimester….prevelene increases up to 7 months

Neville and Damm (72 decks)

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