Chapter 12 Flashcards
What term describes a reactive hyperplasia of CT in response to local irritation or trauma?
Fibroma
What is the most common site of a fibroma?
Buccal muscosa along the occlusal line
What is the common clinical presentation of a fibroma?
An asymptomatic, sessile, smooth surface nodule that is similar in color to the surround mucosa
What is the treatment for a fibroma?
Conservative surgical excision– Must submit to pathology
What is the most common tumor of the oral cavity, and why is it not a true tumor?
Fibroma, not a true tumor since it is an inflammatory response
What term describes a fibrous tumor with distinctive features and is not associated with chronic irritation?
Giant cell fibroma
What is the clinical presentation of a giant cell fibroma?
They usually stay small (<1 cm), and typically have a papillary surface (like cobblestone)
In what population are giant cell fibromas more common?
They usually occur at a younger age than other fibromas
Where do giant cell fibromas usually occur?
Predilection for the gingival
What term describes a typically bilateral nodule on gingiva, lingual to the mandibular cuspid?
Retrocuspid papilla
What is the treatment for a retrocuspid papilla?
None, they usually regress with age! But make note in patients chart
What is the treatment for a giant cell fibroma?
Conservative surgical excision
What term describes a tumor like hyperplasia of fibrous CT?
Inflammatory fibrous hyperplasia
What term describes inflammatory fibrous hyperplasia associated with the flange of an ill fitting denture?
Epulis fissuratum
Where does epulis fissuratum usually occur?
On the facial aspect of the alveolar ridge
What is the treatment for inflammatory fibrous hyperplasia?
Surgical remocal and if associated with a denture, then remake the denture
What term describes a reactive tissue growth that develops under a denture and ahs a pebbly or papillary surface?
Inflammatory papillary hyperplasia
What is inflammatory papillary hyperplasia related to?
Ill fitting denture, poor denture hygiene, or wearing denture 24 hours a day
What percentage of patients that continually wear their denture have inflammatory papillary hyperplasia?
20% of patients
What is the clinical presentation of inflammatory papillary hyperplasia?
Asymptomatic, erythematous tissue with a pebbly or papillary surface
What other infection do patients also have in association with inflammatroy papillary hyperplasia?
Candidal infection (dentur stomatitis/erythematous candida)
How is inflammatory papillary hyperplasia treated?
Early lesions, removal of the denture and antifungal therapy. For advanced lesions, surgical removal may be needed
What term describes a lesion that results from overproduction of hyaluronic acid by fibroblasts?
Oral focal mucinosis
The skin counterpart of oral focal mucinosis is called ________ _______ ______.
Cutaneous focal mucinosis
In what population are oral focal mucinosis more common?
Most common in young females
Where do oral focal mucinosis nodules occur?
2/3 occur on the gingiva, 1/3 occur on the hard palate
How is oral focal mucinosis treated?
Surgical excision
What term describes a reactive lesion to local irritation or trauma that is not a true granuloma?
Pyogenic granuloma
Where doe pyogenic granulomas usually occur?
Gingiva (75%), then lips, tongue and buccal mucosa
In what population are pyogenic granulomas most common?
In children and young adults
What is the clinical presentation of a pyogenic granuloma?
Smooth or lobulated pink or red mass that is typically pedunculated, and may exhibit rapid growth. Surface is characteristically ulcerated and bleeds easily
What are 2 other names for a pyogenic granuloma?
Pregnancy tumor or granuloma gravidarum
Why are pyogenic granulomas typically red in appearance?
Because of the capillary blood vessels within it
What is the treatment for a pyogenic granuloma?
Surgical excision, and for gingival lesions the excision should extend to the periosteum and adjacent teeth. For lesions developing during pregnancy, defer treatment because sometimes the lesion will resolve after birth, unless functional or aesthetic problems develop.
Is it common for pyongenic granulomas to recur?
Yes, they can occasionally recur
What term describes a reactive lesions caused by local irritation or trauma that may produce a cupping resorption of the underlying alveolar bone?
Peripheral giant cell granuloma
Where do peripheral giant cell granulomas occur?
They occur exclusively on the gingiva or edentulous alveolar ridge
What is the clinical presentation of a peripheral giant cell granuloma?
Erythematous mass similar to a pyogenic granuloma (ulcerated about half the time) but is often more blue or purple.
In what population and age do peripheral giant cell granulomas usually occur?
At 35, 60% in females
How is a peripheral giant cell granuloma treated?
Surgical excision down to underlying bone and adjacent teeth should be scaled
Is recurrence common for peripheral giant cell granulomas?
No, 10% recur
What term describes a nodular mass due to irritation or trauma that is not usually erythematous, may or may not have bone formation within the mass (white appearance)?
Peripheral ossifying granuloma
Where do peripheral ossifying granulomas usually occur?
Exclusively on the gingiva, commonly in the incisor-cuspid region (… they arise from the dental papilla)
In what population and at what age do peripheral ossifying granulomas most commonly occur?
At 15, 2/3 in females
What is the treatment for a peripheral ossifying fibroma?
Surgical excision down to the underlying bown, and scaling of the adjacent teeth
Is it common for peripheral ossifying fibromas to recur?
No, 15% recur
What term describes a benign tumor of fat?
Lipoma
A lipoma is the most common ____ _______.
Most common mesenchymal neoplasm
Where do lipomas usually occur?
On that trunk, but intraorally they occur on the buccal mucosa
In what population and at what age are lipomas most common?
In obese patients, and most patients are older than 40
What is the clinical presentation of a lipoma?
A yellow or mucosal colored soft, smooth surfaced nodular mass
What is the diagnostic characteristic of lipomas?
They float in formalin
How are lipomas treated?
Surgical excision
What term describes a proliferation of neural tissue?
Neuroma
What are the 2 types of neuromas?
Traumatic neuromaor palisaded encapsulated neuroma
What is the most common location for a traumatic neuroma?
Most common in the mental foramen area
Why are traumatic neuromas not true neoplasms?
Because they occur after nerve injury
What is the treatment for traumatic neuroma?
Surgical excision
What term describes a benign neural neoplasm of schwann cell origin?
Schwannoma
What is another name for schwannoma?
Neurilemoma
Describe the growth of a schwannoma
A slow growing, encapsulated tumor which arises in association with a nerve trunk, and is typically asymptomatic
In what population are schwannomas most common?
In young and middle aged adults
What is the most common site of occurence of schwannomas?
The tongue
What are the histopathologic features of a schwannoma?
Antoni A and Antoni B features
Describe Antoni A
Streaming fascicles of spindle-shaped Schwann cells which form a palisaded arrangement around central acellular, eosinophilic areas known as verocay bodies
What is the most common type of peripheral nerve neoplasm?
Neurofibroma
Neurofibromas can be a component of what disease?
Neurofibromatosis, or they can arise as solitary tumors
In what population are neurofibromas most common?
In young adults
Describe the clinical presentation of neurofibromas?
Slow growing, soft, painless lesions
Where do neurofibromas most commonly occur?
In skin, but intraorally they occur on the tongue and the buccal mucosa
How are neurofibromas treated?
Surgical excision, but any patient with a lesion diagnosed as a neurofibroma must be evaluated for neurofibromatosis
What is the most common form of neurofibromatosis?
Neurofibromatosis type I
What is another name for neurofibromatosis type I?
von Recklinghausen’s disease of the skin
Is NF type I autosomal dominant or recessive?
Autosomal dominant
What is the pathognomonic characteristic or NF I?
Plexiform variant of neurofibromatosis
Describe plexiform variant of neurofibromatosis
Feels like a bag of worm
What are the diagnostic criteria for neurofibromatosis?
6+ cafe au lait macules that have coast of california border, 2+ NF or 1 plexiform NF, Crowe’s signs, optic glioma, 2+ iris hamartomas (lisch nodules), osseous lesion (like sphenoid dysplasia), 1st degree relative with NF1
What are the oral manifestations of NF1? (oral manifestations occur in 90%)
Enlargement of the fungiform papilla (in 50%), intraoral neurofibromas (in 25%), enlargement of the mandibular foramen or canal
What is treatment for NF1?
Prevention or management of complications, and genetic counseling is extremely important
What malignancies are associated with NF1?
Malignant peripheral nerve sheath tumors (up to 5%), and other various malignancies
What is a characteristic feature of neurofibromatosis type II?
Bilateral schwannomas of auditory vestibular nerve
Is NF II autosomal recessive or dominant?
Autosomal dominant
What is the cause of NF II?
Mutation of a tumor suppressor gene on chromosome 22
What are the other features of NFII?
Acoustic neuromas of vestibular nerve, meningiomas and ependymomas of the CNS
What are some symptoms of NFII?
Deafness, dizziness, tinnitus
