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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
What is florid cemento-osseous dysplasia?
Involvment of multiple loci not limited to the anterior mandible
26
At what age and in what population is florid cemento-osseous dysplasia most common?
Middle aged adults, 90% females, and 90% are African Americans
27
What is unique about the clinical presentation of florid cemento-osseous dysplasia?
It has a marked tendency to be bilateral and symmetrical, and the teeth are not mobile
28
What is important to remember when treating patients with periapical and florid cemento-osseous dysplasia?
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
29
What term describes a neoplasm composed of fibrous tissue and a mixture of bone and cementum?
Ossifying fibroma
30
What are some clinical and radiographic characteristics of ossifying fibromas?
Painless swellings, that radiographically are well defined, typically unilocular, and may cause root divergence or resorption
31
What is unique about large ossifying fibromas in the mandible?
Lesions exhibit a characteristing downward bowing of the inferior cortex of the mandible
32
What is the prognosis of ossifying fibroma?
Prognosis is very good with rare recurrence, and these tumors do not undergo malignant transformation
33
What term describes a more aggressive form of ossifying fibroma, that usually occurs in adolescents?
Juvenile (active) ossifying fibroma
34
How is juvenile (active) ossifying fibroma different from ossifying fibromas?
Occurs in males, in the maxilla and can exhibit more aggressive
35
What are some clinical and radiographic characteristics of juvenile (active) ossifying fibromas?
Rapidly growing, well circumscribed radiopaque lesions with a radiolucent rim
36
What is the prognosis for juvenile (active) ossifying fibromas?
Large tumors require wide resection, and recurrence is between 30-60%, but there is no malignant transformation
37
What term describes a benign tumor of mature bone?
Osteoma
38
Where do osteomas occur?
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
At what age do osteomas occur?
In young adults
40
What are some clinical and radiographic characteristics of osetomas?
Asymptomatic, solitary lesions that may cause pain, swelling, sinusitis or nasal discharge. Radiographically they are circumscribed masses that are usually RO
41
How are osteomas treated?
Conservatice excision
42
What complex syndrome is associated with osetomas?
Gardner syndrome
43
What are the 7 characteristics associated with Gardner syndrome?
Colonic poylps/adenocarcinoma, skeletal abnormalities (osteomas), dental abnormalities, epidermoid cysts, dermoid tumors, thyroid carcinoma, pigmented lesions of the ocular fundus
44
How many people are affected by Gardner syndrome?
About 1 in 10,000
45
When do bowel polyps associated with Gardner syndrome develop?
During teenage years and they will transform into adenocarcinoma
46
Where do osteomas associated with Gardner syndrome occur?
Affect the skull, paranasal sinuses, and mandible
47
What are some of the other dental abnormalities associated with Gardner syndrome?
Supernumerary teeth, impacted teeth, and odontomas
48
How is Gardner's syndrome treated?
Prophylactic colectomy -- prognosis depends on development of bowel adenocarcinomas
49
What terms describes 2 closely related, benign bone tumors that arise from osteoblasts?
Osteoblastoma and osteoid osteoma
50
How do osteoblastoma and osteoid osteoma differ?
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
What are some clinical and radiographic characteristics of osteoblastoma and osteoid osteomas?
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
What is the prognosis of osteoblastomas and osteo osteomas?
Prognosis is good, no malignant transformation, 50% recur
53
What term describes an odontogenic neoplasm of cementoblasts?
Cementoblastoma
54
Where do cementoblastomas occur?
75% in the mandible, and almost always in the molar/premolar region
55
At what age do cementoblastomas usually occur?
75% occur before 30
56
What are some clinical and radiographic characteristics of cementoblastomas?
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
How is cementoblastoma treated?
Surgical extraction of the tooth with the calcified mass
58
What term describes rare, benign development of cartilagenous nodules within the synovial membrane?
Synovial chondromatosis
59
Where does synovial chondromatosis usually occur?
Most commonly occurs in large joints but can affect the TMJ
60
At what age and in what population does synovial chondromatosis usually occur?
Middle aged, females
61
What are some clinical and radiographic characteristics of synovial chondromatosis?
Swelling, pain, crepitus, limitation of motion, as well as irregularly shaped RO structures around joint (joint mice)
62
How is synovial chrondromatosis treated?
Surgical removal of all the synovium and all loose bodies
63
What term describes a mesenchymal malignancy where cells have the ability to produce osteoid or immature bone?
Osteosarcoma
64
Osteosarcoma is the most common malignancy ____________
Most common malignancy to originate within bone (besides hematopoietic neoplasms)
65
What is the most common place for osteosarcomas to arise in young patients?
Distal femur and proximal tibia
66
At what age do extragnathic osteosarcomas commonly occur?
More commonly between 10-20, and after 50
67
At what age do gnathic osteosarcomas occur?
Occur around 33
68
Where do gnathic osteosarcomas usually occur?
Mx = md In mandible = posterior jaws In maxilla = alveolar ridge, sinus floor, palate
69
What are some clinical and radiographic characteristics of osteosarcoma?
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
What is the risk of metastasis of gnathic osteosarcomas?
Gnathic lesions have less tendency to metastasize than long bone osteosarcoma
71
What term describes a sarcoma that arises in bone that has previously been subjected to radiation tx?
Postirradiation bone sarcoma
72
What are the common types of sarcomas that occur in postirradiation bone sarcoma?
Osteosarcoma is most common, then fibrosarcoma, then chondrosarcoma
73
When do postirradiation bone sarcomas usually occur?
Usually 15 years after tx, but may be 3 years after
74
What term describes a malignant bone tumor of cartilage?
Chondrosarcoma
75
Where does chondrosarcoma occur in the head and neck?
In the maxilla (4:1 compared to md)
76
At what age does chondrosarcoma usually occur?
Average age = 40
77
Why is it difficult to determine the extent of a chondrosarcoma radiographically?
Chondrosarcomas demonstrate extensive infiltration between trabeculae of bone without causing resorption
78
What term describes a primary malignant tumor of bone that is caused by a translocation of chromosomal material between chromosomes 11 and 22?
Ewing sarcoma
79
What is the most common cancer involving bone?
Metastatic cancer
80
What is the most common origin of gnathic mets?
Lung, Breast or Prostate, Kidney, Thyroid
81
What is the most common site of metastasis to the oral cavity?
The gingiva (2/3), but 1/3 occur in the amndible
82
What are some signs or gnathic mets?
Pain, swelling, loosening of teeth, paresthesia
83
When metastasis to the manible has IAN involvement, what distinctive pattern of anesthesia is occasionally produced?
Numb-chin synrome
84
How may gnathic mets be discovered?
In non healing extraction sites!
85
What are some radiographic signs of malignancy in the jaw?
Ill defined borders (moth eaten), widening of the PDL ligament, varying degrees of RL/RO lesions
86
What is the prognosis of metastasis?
Poor because it is already a Stage IV disease, and patients usually succumb to cancer within a year!
87
What term describes a benign tumor of cartilage?
Chondroma
88
Where do chondromas commonly occur?
In the hands and feet
89
Where do chondromas commonly occur in the head and neck?
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
At what age do chondromas usually occur?
20-30s
91
What are some clinical and radiographic features of chondromas?
Painless, slow growing masses that are radiolucent with central RO

Oral Pathology - My deck (22 decks)

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