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Dr. Murrahs class > Chapter 15: Odontogenic Cysts and Tumors Part II > Flashcards

Chapter 15: Odontogenic Cysts and Tumors Part II Flashcards

1
Q

___ is a developmental odontogenic cyst which typically occurs along the lateral root surface

A

lateral periodontal cyst

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2
Q

lateral periodontal cysts arise from ___

A

cell rests of the dental lamina

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3
Q

which 3 odontogenic cysts are derived from cell rests of the dental lamina?

A
  • odontogenic keratocyst
  • gingival cyst of the adult
  • lateral periodontal cyst
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4
Q

lateral periodontal cysts are the intrabody counterpart of the ___

A

gingival cyst of the adult

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5
Q

lateral periodontal cysts are found in patients of what age?

A

40-60

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6
Q

lateral periodontal cysts have a striking predilection to occur in what location?

A

mandibular premolar-canine-lateral incisor area

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7
Q

are teeth affected by lateral periodontal cysts vital or non-vital?

A

vital

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8
Q

how do lateral periodontal cysts present radiographically?

A
  • well-circumscribed RL
  • occasionally, the lesion may appear polycystic, termed botryoid odontogenic cysts
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9
Q

___ usually appear multilocular via xray and represent a rare variant of the lateral periodontal cyst

A

botryoid odontogenic cysts

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10
Q

what is the treatment of lateral periodontal cysts?

A

conservative enucleation

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11
Q

what is the recurrance and malignant transformation of lateral periodontal cyst?

A

recurrence and malignant transformation are exceedingly rare

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12
Q
A

lateral periodontal cyst

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13
Q
A

lateral periodontal cyst

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14
Q
A

lateral periodontal cyst

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15
Q

calcifying odontogenic cyst is also called ___

A

gorlin cyst

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16
Q

the WHO reclassified calcifying odontogenic cyst to be ___, but most clinicians refer to it as ___

A
  • calcifying cystic odontogenic tumor
  • gorlin cyst
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17
Q

65% of calcifying odontogenic cysts are found in what location?

A
  • incisor-canine areas
  • mx = md
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18
Q

what is the average age patient with a calcifying odontogenic cyst?

A

35

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19
Q

20% of calcifying odontogenic cysts are associated with ___

A

odontomas

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20
Q

what are the radiographic features of calcifying odontogenic cysts?

A
  • unilocular, well-defined radiolucency
  • radiopaque structures are seen within the RL in 50%
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21
Q

1/3 of calcifying odontogenic cysts are associated with a ___

A

unerupted tooth (usually canine)

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22
Q

what are the histopathologic features of calcifying odontogenic cysts?

A

has ghost cells, which can calcify

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23
Q

what is the recurrence of calcifying odontogenic cysts? what is the prognosis?

A

rare recurrences have been reported after enucleation

prognosis is good

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24
Q
A

calcifying odontogenic cyst

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25
Q
A

calcifying odontogenic cyst

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26
Q
A

calcifying odontogenic cyst

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27
Q

___ is a developmental cyst with glandular and/or salivary gland features

A

glandular odontogenic cyst

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28
Q

what is the average age of someone with a glandular odontogenic cyst?

A

50 years old

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29
Q

75% of glandular odontogenic cyst cases occur in what location?

A

mandible, with a predilection for the anterior jaws

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30
Q

describe the size of glandular odontogenic cysts

A

can vary from small to very large

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31
Q

what are the radiographic features of glandular odontogenic cysts?

A
  • either unilocular or multilocular radiolucency
  • well-defined margins
  • sclerotic rim
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32
Q

what is the treatment for a glandular odontogenic cyst? what is the recurrence rate?

A
  • enucleation with curettage
  • 30% will recur
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33
Q
A

lateral periodontal cyst

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34
Q

of multilocular vs unilocular glandular odontogenic cyst lesions, which is more likely to recur?

A

multilocular (because they’re harder to get out)

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35
Q

because multilocular glandular odontogenic cyst lesions are more likely to recur than unilocular lesions, ___ is used at times

A

en bloc resection

*difference between en bloc vs complete resection: complete resection is complete, through-through removal; en bloc leaves a border of the mandlbe there

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36
Q
A

glandular odontogenic cyst

37
Q

___ is an inflammatory cyst with uncertain pathogenesis, which characteristically develops on the buccal aspect of the mandibular first permanent molar

A

buccal bifurcation cyst

38
Q

what age patient do buccal bifurcation cysts commonly affect?

A

children, average age 10

39
Q

what are some common experiences a patient may have with a buccal bifurcation cyst?

A
  • tenderness
  • swelling
  • foul-tasting discharge
40
Q

in a patient with a buccal bifurcation cyst, what does perio probing usually reveal?

A

pocket formation on the buccal aspect

41
Q

1/3 of buccal bifurcation cysts have ___ involvement

A

bilateral

42
Q

what are the radiographic features of buccal bifurcation cysts?

A
  • well-circumscribed, unilocular radiolucency involving the buccal bifurcation and root
  • average size is 1.5 cm
  • an occlusal xray can demonstrate buccal location
  • the root apices are characteristically tipped toward the lingual mandibular cortex
43
Q

what is the treatment of buccal bifurcation cysts?

A

enucleation

no need to extract the tooth

44
Q

when is complete healing usually achieved with the treatment of a buccal bifurcation cyst?

A

within 1 year of surgery

45
Q
A

buccal bifurcation cyst

46
Q
A

buccal bifurcation cyst

47
Q

___ is a carcinoma arising within bone, is rare, and essentially limited to the jaws

A

carcinoma arising in odontogenic cysts

48
Q

carcinomas arising in odontogenic cysts are collectively known as ___

A

odontogenic carcinomas

49
Q

most odontogenic carcinomas arise from ___

A

odontogenic cysts

50
Q

1-2% of all oral cavity carcinomas originate from ___

A

odontogenic cysts

51
Q

what is the pathogenesis of carcinomas arising in odontogenic cysts?

A

unknown

52
Q

carcinomas arising in odontogenic cysts are typically seen in what age patient?

A

older patients

53
Q

___ and ___ are the two most common presenting symptoms of carcinomas arising in odontogenic cysts; however, some patients are asymptomatic

A

pain and swelling

54
Q

radiographically, carcinomas arising in odontogenic cysts mimic ___, except the margins are ___ and ___

A
  • odontogenic cysts
  • irregular and ragged
55
Q

what is the histology of carcinomas arising in odontogenic cysts?

A

usually shows well-differentiated SCCA

56
Q

what is the treatment for carcinomas arising in odontogenic cysts?

A

varies from local block excision to radical resection, +/- radiation and chemo

57
Q

approximately ___% of patients treated for carcinoma arising in odontogenic cysts survive

A

50%

58
Q

when diagnosing carcinomas arising in odontogenic cysts, you must rule out ___ before calling it a true primary intraosseous carcinoma

A

metastatic spread from another area

59
Q
A

carcinoma arising in odontogenic cysts

60
Q

what is the differential for a cyst that crosses the midline?

A
  • glandular odontogenic cyst
  • odontogenic keratocyst
  • central giant cell granuloma
  • traumatic bone cyst - not a true cyst, no expansion
61
Q

___ is the most common clinically significant odontogenic tumor

A

ameloblastoma

62
Q

ameloblastomas are tumors of ___ origin

A

odontogenic epithelial

63
Q

what are the 3 different types of ameloblastomas and their relative prevalences?

A
  • conventional solid or multicystic - 85%
  • unicystic - 15%
  • peripheral - 1%
64
Q

what age are ameloblastomas most common?

A

equal prevalence from 3rd-7th decade of life

65
Q

what is the gender predileciton of ameloblastomas?

A

none

66
Q

85% of ameloblastomas occur where?

A

in the mandible, usually the molar-ascending ramus area

67
Q

are ameloblastomas symptomatic or asymptomatic?

A

asymptomatic, smaller ones are usually detected during routine xrays

68
Q

what is the clinical sign of ameloblastoma?

A

if there is on, it’s most often a painless swelling

69
Q

what can happen if ameloblastomas are untreated?

A

they can grow to grotesque portions - even then, pain and parasthesia are uncommon

70
Q

what are the radiographic features of ameloblastomas?

A
  • typical features is a multilocular radiolucency
    • “soap bubble” - when RL loculations are large
    • “honeycombed” - when the loculations are small
    • buccal and lingual cortical expansion is frequently present
71
Q

is there root resorption associated with ameloblastomas?

A

yes

72
Q

a ___ may be associated with an ameloblastoma

A

unerupted tooth

73
Q

which pattern of ameloblastomas does not share features with the other forms, has a predilection for the anterior maxilla, and may be mixed RL-RO (due to osseous metaplasia)?

A

desmoplastic ameloblastoma

74
Q

what is the histopathology of ameloblastomas?

A
  • palisading, hyperchromatic basal layer
  • reverse polarity
  • apical vacuolization
75
Q

what is the treatment for patients with conventional solid or multicystic ameloblastomas?

A

variety of treatment, from simple enucleation and curettage to en bloc resection

76
Q

ameloblasts infiltrate between ___ at the lesion periphery

A

cancellous bone

77
Q

in early stages of ameloblastoma, ___ cannot be seen via radiographs

A

bone resorption

78
Q

what are the recurrence rates when ameloblastomas are curettaged?

A

50-90%

recurrence takes years

79
Q

what is the most widely used treatment for ameloblastomas, and what is the recurrence rate?

A
  • marginal resection - 1.5cm margins beyond what is visible radiographically
  • recurrence is 15%
80
Q
A

ameloblastoma

81
Q
A

ameloblastoma

82
Q
A

ameloblastoma

83
Q
A

ameloblastoma

notice the soap bubble appearance

84
Q
A

ameloblastoma

notice the honeycombed appearance

85
Q
A

ameloblastoma

86
Q
A

ameloblastoma

this is multilocular, so it can’t be a lateral periodontal cyst

87
Q
A

ameloblastoma

88
Q
A

ameloblastoma

Dr. Murrahs class (17 decks)

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