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Oral Pathology - My deck > Chapter 14 - Part 2 > Flashcards

Chapter 14 - Part 2 Flashcards

1
Q

What term describes lesions that are characterized by a replacement of normal bone by fibrous tissue?

A

Fibro-osseous lesions

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2
Q

What are some examples of benign fibro-osseous lesions?

A

Fibrous dysplasia, cemento-osseous dysplasia, ossifying fibroma

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3
Q

What are the 2 types of fibrous dysplasia?

A

Monostotic and Polyostotic

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4
Q

What is the cause of fibrous dysplasia?

A

Sporadic condition resulting from a post zygotic mutation, that depending on when the mutation took place, the condition can involve bone, skin or the endocrin system

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5
Q

How many cases does monostotic firbous dysplasia account for?

A

About 80% of fibrous dysplasia cases

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6
Q

What is one of the most commonly affected sites of monostotic fibrous dysplasia?

A

The jaws, Maxilla >Mandible

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7
Q

When is monostotic fibrous dysplasia usually diagnosed?

A

In teenage years

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8
Q

What are some clinical and radiographic features of monostotic fibrous dysplasia?

A

Painless, slow growing swelling that has a “ground glass” opacification, and is not well demarcated

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9
Q

How does expansion of monostotic fibrous dysplasia lesions differ between the mandible and maxilla?

A

In the mandible, expansion will involve both the buccal and lingual plates. In the maxilla, expansion leads to obliteration of the maxillary sinus

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10
Q

What is Polyostotic fibrous dysplasia?

A

When 2 or more bones are involved, but cases have shown up to 75% of skeleton to be involved

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11
Q

What are the 3 syndromes associated with polyostotic fibrous dysplasia?

A

Jaffe-Lichtenstein syndrome, Mccune-Albright syndrome, and Mazabraud syndrome

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12
Q

What are the characteristics of Jaffe-Lichtenstein syndrome?

A

Polyostotic firbous dysplasia and cafe au lait spots with coasts of Maine

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13
Q

What are the characteristics of McCune Albright syndrome?

A

Polyostotic fibrous dysplasia, cafe au lait spots with coasts of Maine, and Multiple endocrinopathies

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14
Q

What are the common endocrinopathies associated with McCune-Albright syndrome?

A

Sexual precocity, pituitary adenoma, and/or hyperthyroidism

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15
Q

How is polyostotic fibrous dysplasia treated?

A

Clinical management is a major problem, but lesions may be reduced surgically. About 50% recur and radiation tx is contraindicated

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16
Q

What is the most common fibro-osseous lesion encountered in clinical practice?

A

Cemento-osseous dysplasia

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17
Q

What are the 3 types of cemento-osseous dysplasia?

A

Focal, Periapical, Florid

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18
Q

What is focal cemento-osseous dysplasia?

A

Single sight of involvement

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19
Q

At what age and in what population is focal cemento-osseous dysplasia most common?

A

Average age is 40, and 90% occur in females

Boards= caucasian, Reality = African americans

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20
Q

Where is the most common location of focal cemento-osseous dysplasia?

A

The posterior mandible

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21
Q

What are some clinical and radiographic characteristics of focal cemento-osseous dysplasia?

A

Lesions are smaller than 1.5 cm, and will have a radiolucent rim

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22
Q

What is periapical cemento-osseous dysplasia?

A

Involvement of the periapical region of the anterior mandible, can have multiple foci

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23
Q

At what age and in what population is periapical cemento-osseous dysplasia most common?

A

Average age is 40, 90% in female and 70% in African Americans

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24
Q

What are some clinical and radiographic characteristics of periapical cemento-osseous dysplasia?

A

Teeth are vital, and not mobile or asymptomatic. Radiopaque lesions with radiolucent rims that involve the apex of a tooth

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25
Q

What is florid cemento-osseous dysplasia?

A

Involvment of multiple loci not limited to the anterior mandible

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26
Q

At what age and in what population is florid cemento-osseous dysplasia most common?

A

Middle aged adults, 90% females, and 90% are African Americans

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27
Q

What is unique about the clinical presentation of florid cemento-osseous dysplasia?

A

It has a marked tendency to be bilateral and symmetrical, and the teeth are not mobile

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28
Q

What is important to remember when treating patients with periapical and florid cemento-osseous dysplasia?

A

Healing is compromised in bone. Avoid extractions and AVOID BIOPSY as it can lead to necrosis, make sure patient has a cleaning every 3 months to prevent caries or perio

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29
Q

What term describes a neoplasm composed of fibrous tissue and a mixture of bone and cementum?

A

Ossifying fibroma

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30
Q

What are some clinical and radiographic characteristics of ossifying fibromas?

A

Painless swellings, that radiographically are well defined, typically unilocular, and may cause root divergence or resorption

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31
Q

What is unique about large ossifying fibromas in the mandible?

A

Lesions exhibit a characteristing downward bowing of the inferior cortex of the mandible

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32
Q

What is the prognosis of ossifying fibroma?

A

Prognosis is very good with rare recurrence, and these tumors do not undergo malignant transformation

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33
Q

What term describes a more aggressive form of ossifying fibroma, that usually occurs in adolescents?

A

Juvenile (active) ossifying fibroma

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34
Q

How is juvenile (active) ossifying fibroma different from ossifying fibromas?

A

Occurs in males, in the maxilla and can exhibit more aggressive

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35
Q

What are some clinical and radiographic characteristics of juvenile (active) ossifying fibromas?

A

Rapidly growing, well circumscribed radiopaque lesions with a radiolucent rim

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36
Q

What is the prognosis for juvenile (active) ossifying fibromas?

A

Large tumors require wide resection, and recurrence is between 30-60%, but there is no malignant transformation

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37
Q

What term describes a benign tumor of mature bone?

A

Osteoma

38
Q

Where do osteomas occur?

A

Restricted to the craniofacial skeleton! And arise on the surface of bone or within the medullary bone – paranasal sinus lesions are more common than gnathic

39
Q

At what age do osteomas occur?

A

In young adults

40
Q

What are some clinical and radiographic characteristics of osetomas?

A

Asymptomatic, solitary lesions that may cause pain, swelling, sinusitis or nasal discharge. Radiographically they are circumscribed masses that are usually RO

41
Q

How are osteomas treated?

A

Conservatice excision

42
Q

What complex syndrome is associated with osetomas?

A

Gardner syndrome

43
Q

What are the 7 characteristics associated with Gardner syndrome?

A

Colonic poylps/adenocarcinoma, skeletal abnormalities (osteomas), dental abnormalities, epidermoid cysts, dermoid tumors, thyroid carcinoma, pigmented lesions of the ocular fundus

44
Q

How many people are affected by Gardner syndrome?

A

About 1 in 10,000

45
Q

When do bowel polyps associated with Gardner syndrome develop?

A

During teenage years and they will transform into adenocarcinoma

46
Q

Where do osteomas associated with Gardner syndrome occur?

A

Affect the skull, paranasal sinuses, and mandible

47
Q

What are some of the other dental abnormalities associated with Gardner syndrome?

A

Supernumerary teeth, impacted teeth, and odontomas

48
Q

How is Gardner’s syndrome treated?

A

Prophylactic colectomy – prognosis depends on development of bowel adenocarcinomas

49
Q

What terms describes 2 closely related, benign bone tumors that arise from osteoblasts?

A

Osteoblastoma and osteoid osteoma

50
Q

How do osteoblastoma and osteoid osteoma differ?

A

In size and consequently if pain from tumor can be relieved by aspirin.
Less than 1 cm = osteoid osteoma
Larger (2-4 cm) = osteoblastoma

51
Q

What are some clinical and radiographic characteristics of osteoblastoma and osteoid osteomas?

A

Both are actually rare in the jaws but if they are in jaws they are not usually in tooth bearing areas?
Pain, tenderness and swelling with varying degrees of central RO/RL (target like)

52
Q

What is the prognosis of osteoblastomas and osteo osteomas?

A

Prognosis is good, no malignant transformation, 50% recur

53
Q

What term describes an odontogenic neoplasm of cementoblasts?

A

Cementoblastoma

54
Q

Where do cementoblastomas occur?

A

75% in the mandible, and almost always in the molar/premolar region

55
Q

At what age do cementoblastomas usually occur?

A

75% occur before 30

56
Q

What are some clinical and radiographic characteristics of cementoblastomas?

A

Pain and swelling in 2/3, with a RO mass that is fused to one or more tooth roots (outlien of root is usually obscured), outlined by thin RL rim

57
Q

How is cementoblastoma treated?

A

Surgical extraction of the tooth with the calcified mass

58
Q

What term describes rare, benign development of cartilagenous nodules within the synovial membrane?

A

Synovial chondromatosis

59
Q

Where does synovial chondromatosis usually occur?

A

Most commonly occurs in large joints but can affect the TMJ

60
Q

At what age and in what population does synovial chondromatosis usually occur?

A

Middle aged, females

61
Q

What are some clinical and radiographic characteristics of synovial chondromatosis?

A

Swelling, pain, crepitus, limitation of motion, as well as irregularly shaped RO structures around joint (joint mice)

62
Q

How is synovial chrondromatosis treated?

A

Surgical removal of all the synovium and all loose bodies

63
Q

What term describes a mesenchymal malignancy where cells have the ability to produce osteoid or immature bone?

A

Osteosarcoma

64
Q

Osteosarcoma is the most common malignancy ____________

A

Most common malignancy to originate within bone (besides hematopoietic neoplasms)

65
Q

What is the most common place for osteosarcomas to arise in young patients?

A

Distal femur and proximal tibia

66
Q

At what age do extragnathic osteosarcomas commonly occur?

A

More commonly between 10-20, and after 50

67
Q

At what age do gnathic osteosarcomas occur?

A

Occur around 33

68
Q

Where do gnathic osteosarcomas usually occur?

A

Mx = md
In mandible = posterior jaws
In maxilla = alveolar ridge, sinus floor, palate

69
Q

What are some clinical and radiographic characteristics of osteosarcoma?

A

Swelling and pain, varying RO/RL presentations, spiking/root resorption, sunburst appearance in bony projections in 25% o cases, Codman’s triangle (periosteum), widening of the PDL

70
Q

What is the risk of metastasis of gnathic osteosarcomas?

A

Gnathic lesions have less tendency to metastasize than long bone osteosarcoma

71
Q

What term describes a sarcoma that arises in bone that has previously been subjected to radiation tx?

A

Postirradiation bone sarcoma

72
Q

What are the common types of sarcomas that occur in postirradiation bone sarcoma?

A

Osteosarcoma is most common, then fibrosarcoma, then chondrosarcoma

73
Q

When do postirradiation bone sarcomas usually occur?

A

Usually 15 years after tx, but may be 3 years after

74
Q

What term describes a malignant bone tumor of cartilage?

A

Chondrosarcoma

75
Q

Where does chondrosarcoma occur in the head and neck?

A

In the maxilla (4:1 compared to md)

76
Q

At what age does chondrosarcoma usually occur?

A

Average age = 40

77
Q

Why is it difficult to determine the extent of a chondrosarcoma radiographically?

A

Chondrosarcomas demonstrate extensive infiltration between trabeculae of bone without causing resorption

78
Q

What term describes a primary malignant tumor of bone that is caused by a translocation of chromosomal material between chromosomes 11 and 22?

A

Ewing sarcoma

79
Q

What is the most common cancer involving bone?

A

Metastatic cancer

80
Q

What is the most common origin of gnathic mets?

A

Lung, Breast or Prostate, Kidney, Thyroid

81
Q

What is the most common site of metastasis to the oral cavity?

A

The gingiva (2/3), but 1/3 occur in the amndible

82
Q

What are some signs or gnathic mets?

A

Pain, swelling, loosening of teeth, paresthesia

83
Q

When metastasis to the manible has IAN involvement, what distinctive pattern of anesthesia is occasionally produced?

A

Numb-chin synrome

84
Q

How may gnathic mets be discovered?

A

In non healing extraction sites!

85
Q

What are some radiographic signs of malignancy in the jaw?

A

Ill defined borders (moth eaten), widening of the PDL ligament, varying degrees of RL/RO lesions

86
Q

What is the prognosis of metastasis?

A

Poor because it is already a Stage IV disease, and patients usually succumb to cancer within a year!

87
Q

What term describes a benign tumor of cartilage?

A

Chondroma

88
Q

Where do chondromas commonly occur?

A

In the hands and feet

89
Q

Where do chondromas commonly occur in the head and neck?

A

In the symphysis, coronoid process, condyles and anterior maxilla – however, chondromas that have been diagnosed in the head have turned out to be malignant so be suspicious of chondromas in the head

90
Q

At what age do chondromas usually occur?

A

20-30s

91
Q

What are some clinical and radiographic features of chondromas?

A

Painless, slow growing masses that are radiolucent with central RO

Oral Pathology - My deck (22 decks)

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