Chapter 12 Soft Tissue Tumors Flashcards
What is this
Peripheral Ossifying Fibroma (POF)
Exclusively on the gingiva
Nodular mass usually from dental papilla
Average age is 15, 2/3s in females
50% are in the incisor cuspid region
What is this
Port wine stain or nevus flammeus
Sturge weber angiomatosis
Rare, nonhereditary developmental condition
Usually occurs along one of more of the branches of the trigeminal nerve
No all patients with a port wine stain have sturge weber angiomatosis
Convulsive disorders (phenytoin)
What is this
Fibroma
Most common tumor in the oral cavity
Reactive hyperplasia of fibrous connective tissue in response to local irritation or trauma
Most common location is along the buccal mucosa along the occlusal plane
What is this
Melanotic Neuroectodermal Tumor of Infancy
Rare pigmented tumor (black and/or blue)
Striking predilection for anterior maxilla (61%)
High urinary levels of VMA (vanillylmandelic acid)
Most are benign
Metastasis to the oral soft tissues
One possible explanation of H&N mets in the absence of lung mets is Batson’s plexus
This is a valveless vertebral venous plexus that might allow retrograde spread of tumor cells & bypass the lungs
Gingiva is the most common site for soft tissue
Usually carcinomas not sarcomas
2/3s of METs go to soft tissue and 1/3 to bone
What is this
Neurofibromatosis Type 1
Hereditary
aka von Recklinghausen’s disease of the skin
Plexiform variant of NF is pathognomonic (feel like a “bag of worms”)
Café au lait (coast of california)
Freckling in the axillary region (Crowe’s sign)
2 or more iris hamartomas (Lisch nodules)
90% have oral lesions
Up to 5% have malignant peripheral nerve sheath tumors
Rhabdomyosarcoma
Malignancy of skeletal muslces
60% of soft tissue sarcomas in childhood
Painless, infiltrative mass that grows rapidly
What is this
Lipoma
Benign tumor of fat
By far the most common mesenchymal neoplasm
Float in formalin
Yellow to pink
What is this
Palisaded Encapsulated Neuroma (PEN)
aka solitary circumscribed neuroma
90% found on the face
Leiomyoma
Benign tumor of smooth muscle
Most oral lesions are a vascular variant (angioleiomyoma)
What is this
Inflammatory papillary hyperplasia (IPH)
Reactive tissue growth under denture, caused by ill fit, poor hygiene, wearing 24/7
20% of patients with dentures have it
Typically occurs on hard palate
Erythematous with pebbly/papillary surface
Patient might also have candida infection
What is this
Peripheral Giant Cell Granuloma (PGCG)
Reactive lesion cause by local irritation or trauma
Exclussively on gingiva or edentulous alveolar ridge
More blue to purple when compared to PG
“Cupping” resorption of the underlying alveolar bone
What is this
Inflammatory fibrous hyperplasia (IFH)
Tumor like hyperplasia of connective tissue
If caused by the flange on an ill fitting denture it is called epulis fissuratum
Usually on the facial surface of the alveolar bone
Surgical removal and remake of denture
What is this
Traumatic Neuroma
Not a true neoplasm; it is a proliferation of neural tissue after nerve injury
Most common in mental nerve area
1/3 are painful
Multiple Endocrine Neoplasia Type 2B (MEN 2B)
Charcterized by tumors of endocrine origin: parathyroid, pituitary, pancrease, adrenal gland (pheochromocytosis, 50%), thryoid (medullary carcinoma, 90%), mucosal neuromas
Marfanoid build
Oral mucosal neuromas are typically the first sign of the condition
Bilateral neuromas of the commissural mucosa are highly characteristic
Marked propensity for metastasis
Diagnosed between 18-25
Rhabdomyoma
Benign tumor of skeletal muscle
Extracardiac rhabdomyomas are very rare but have a predilection for the H&N
Adult and fetal types
70% of adult type are in men, nodular mass occuring in the pharynx or the floor of the mouth
What is this
Pyogenic granuloma (PG)
Reactive lesion from local irritation or trauma
May exhibit rapid growth
75% on gingiva
Most common in children and young adults
Bleeds easily due to extreme vascularity
Red to pink color
Frequently appears in pregnant women (1st trimester) called pregnancy tumor or granuloma gravidarum
What is this
Giant Cell Fibroma
Fibrous tumor with distinctive features, not caused by chronic irritation
Papillary surface
In children it can form on the retrocuspid papilla of the mandible (bilaterally), usually goes away with age
If bilateral there is no need for biopsy (because it is recognized for what it is)
Hemangioma
Most common tumor of infancy
2 types: capillary and cavernous
Capillary: may not blanch clinically, usually red
Cavernous: typically blanches, darker red to purple
Schwannoma
aka Neurilemoma
benign neural neoplasm of of Schwann cell origin
50% of cases in H&N
Bilateral schwannomas of auditory-vestibular nerve are a characteristic feature of the neurofibromatosis type II (NF2)
tongue is the most common location for oral lesions
Antoni-A, organized, verocay bodies
Antoni-B, disorganized
Neurofibroma
Most common type of peripheral nerve neoplasm
can be solitary tumors or part of neurofibromatosis
Most common location for lesions is the skin, and intra oral lesions occur on the tongue and buccal mucosa
If diagnosed with neurofibroma patient must screened for neurofibromatosis
What are 2 types of neuromas?
Traumatic and palisaded encapsulated neruoma
