Chapter 14 lecture 2 Flashcards
What is a diverse group of processes characterized by replacement of normal bone by fibrous tissue containing a mineralized product?
-Fibro-Osseous lesions
What are some examples of benign fibro-osseous lesions?
- Fibrous dysplasia
- Cemento-osseous dysplasia
- Ossifying fibroma
What is characterized by replacement of normal bone by fibrous connective tissue intermixed with bone that is a sporadic condition resulting from a postzygotic mutation?
-Fibrous dysplasia
What is the chief radiographic feature of fibrous dysplasia?
-Fine ground glass opactification
What are the two syndromes found in the polyostotic fibrous dysplasia?
- Jaffe-Lichtenstein syndrome
- McCune-Albright Syndrome
What is the most common type of fibrous dysplasia?
-Monostotic in the maxilla
When is monostotic fibrous dysplasia usually diagnosed?
-Teenage years
What is the most common feature of monostatic fibrous dysplasia?
-Slowly growing swelling of the affected area
What do you see in Jaffe-Lichtenstein syndrome?
- Polyostotic fibrous dysplasia
- Cafe au lait spots (Coast of Maine)
What do you see in McCune-Albright syndrome?
- Polyostotic fibrou dysplasia
- Cafe au laite spots (Coast of maine)
- Multiple endocrinopathies
Where does cemento-osseous dysplasia occur?
-Tooth bearing areas of the Jaw
What is the most common fibro-osseous lesion encountered in clinical practice?
-Cemento-Osseous dysplasia
What are the three types of cemento-osseous dysplasia?
- Focal
- Periapical
- Florid
What does focal-Cemento-osseous dysplasia exhibit?
-Single sight of involvement
Where is the most common place of focal cemento-osseous dysplasia?
-Posterior mandible
Who do you see periapical cemento-osseous dysplasia in?
-Female African americans around 40
Where do you see periapical cemento-osseous dysplasia?
-Periapical region of the anterior mandible
What is florid cemento-osseous dysplasia?
-Multiple focal involvement not limited to the anterior mandible
Is cemento-osseous dysplasia symptomatic?
-No
Who do you see florid cemento-osseous dysplasia in?
-Female African Americans
What might extraction of a tooth in a person with florid COD lead to?
-Necrosis
What type of cemento-osseous dysplasia do you biopsy?
-Focal
What is an ossifying fibroma?
-True neoplasm with significant growth potential
What do early lesions of Cemento-osseous dysplasia appear as?
Radiolucent
What do middle lesions of cemento-osseous dysplasia appear as?
-Radiolucent with Radioopacitiy
What has large ossifying fibromas of the mandible demonstrate a characteristic downward bowing of the inferior cortex of the mandible?
-Ossifying fibroma
How do you distinguish between juvenile ossifying fibroma from an ossifying fibroma?
- Age of patient
- Most common sites of involvement
- Clinical behavior
Where does juvenile ossifying fibromas occur more commonly?
-Maxilla
Who does juvenile ossifying fibromas occur more commonly in?
-Males
Where does ossifying fibromas occur more commonly?
-Mandible
Who does ossifying fibromas occur more commonly in?
-Females
What is an osteoma?
-Benign tumors of mature bone
Where is an osteoma restricted to?
-Craniofacial skeleton
Where does osteoma arise on?
-Surface of bone or within medullary bone
T/F Osteomas exhibit continued growth
True
What characterizes Gardner syndrome?
- Clonic polyps
- Skeletal abnormalities
- Dental abnormalities
- Epidermoid cysts
- Dermoid tumors
- Thyroid carcinoma
- Pigmented lesions of the ocular fundus
In Gardner syndrome what will bowel polyps transform into?
-Adenocarcinoma
What skeletal abnormalities do you most commonly see in Gardner syndrome?
-Osteomas
What dental abnormalities do you see in Gardner syndrome?
- Supernumerary teeth
- Impacted teeth
- Odontomas
What treatment do you need to do in Gardner syndrome?
-Prophylactic colectomy
What are closely related benign bone tumors?
- Osteoblastoma
- Osteoid Osteoma
What does osteoid osteoma produce?
-Prostaglandins
What is the pain relieved by in osteoid osteoma?
-Aspirin
What are the size of osteoid osteomas?
-Smaller than 2 cm
What are the size of osteoblastomas?
-Larger than 2 cm
T/F Osteoblastomas are painful
True
What type of pain do you see in osteoid osteoma?
-Nocturnal
What is a cementoblastoma?
-Odontogenic neoplasm of cementoblasts
Where do most cementoblastomas occur?
-Mandible in the molar/premolar region
If you can see the root outline/PDL in the radioopacity will it be a cementoblastoma?
-No
What is a chondroma?
-Benign tumor of cartilage
T/F Synovial chondromatosis is a rare, benign , non neoplastic tumor
True
Where does synovial chondromatosis most commonly affect?
-Large joints but can affect the TMJ
What are some common features of synovial chondromatosis?
- Swelling
- Pain
- Crepitus
- Limitation of motion
What do you see in an XRAY in someone with synovial chondromatosis?
-Loose bodies
What is an osteosarcoma?
-Mesenchymal malignancy
If you exclude hematopoietic neoplasma what is the most common type of malignancy to originate within bone?
-Osteosarcoma
Whais the most common malignancy of bone?
-Metastatic disease
Extragnathic osteosarcomas have a bimodal age distrubution, when does it occur?
- 10-20 yrs most common
- After 50
What is the most common place for osteosarcomas to arise in young pts?
- Distal femur
- Proximal tibia
When do ostosarcomas of the jaw occur?
-around age 33
In an XRAY you see a sunburst appearance, what should you be thinking of?
-Osteosarcoma
A triangular elevation of periosteum associated with osteosarcoma is termed what?
-Codman’s triangle
Root resorption which is termed spiking resorption is associated with what?
-Osteosarcoma
What is a Juxtacortical osteosarcoma aka?
-Peripheral osteosarcoma
What is a chondrosarcoma?
-Malignant bone tumor of cartilage
What is ewing sarcoma?
-Primary malignant tumor of bone
What is the 3rd most common osseous neoplasm?
-Ewing sarcoma
If you see the onionskin in an XRAY what are you thinking of?
-Ewing sarcoma
What is the most common form of cancer involving bone?
-Metastatic tumor
What are the most common origins of Gnathic mets?
- Breast
- Lung
- Thyroid
- Prostate
- Kidney
What is a numb-chin syndrome associated with?
-Metastatic tumor
If you see the moth-eaten feature in an XRAY what are you thinking?
-Metastatic tumor