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

Chapter 15: Odontogenic Cysts and Tumors Part III Flashcards

1
Q

___ is a painless, nonulcerated, sessile gingival lesion, that is clinically determined to be one of the 3Ps (bump on the gum)

A

peripheral ameloblastoma

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2
Q

what is the average age of someone with a peripheral ameloblastoma?

A

50

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3
Q

where are peripheral ameloblastomas most commonly found?

A

mandibular posterior gingival mucosa

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4
Q

unlike intraosseous ameloblastomas, ___ have innocuous clinical behavior

A

peripheral ameloblastomas

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5
Q

what is the recurrence of peripehral ameloblastomas?

A

15%, and further excision has close to 0% recurrence

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6
Q
A

peripheral ameloblastoma

keep in mind that although this is in the anterior maxilla, most peripheral ameloblastomas are found in the posterior mandible

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7
Q

malignant ameloblastomas have histologic features of a ___, but shows metastatic deposits (what is the most common site for metastatic deposits?)

A
  • conventional ameloblastoma
  • lung most common site
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8
Q

ameloblastic carcinoma has ___ features and follows a markedly aggressive course

A

cytologic malignant

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9
Q

___ develops later in life than conventional ameloblastomas and malignant ameloblastomas

A

ameloblastic carcinoma

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10
Q

are ameloblastic carcinomas aggressive? what are the radiographic features?

A
  • yes
  • ill-defined margins and cortical destruction
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11
Q
A

ameloblastic carcinoma

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12
Q

adenomatoid odontogenic tumors occur in what age patient?

A

ages 10-20 (very uncommon in patients over the age of 30)

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13
Q

what are the common locations of adenomatoid odontogenic tumors? gender predilection?

A
  • anterior maxilla
  • F>M
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14
Q

most adenomatoid odontogenic tumors are what size? they may also rarely occur ___

A
  • small
  • peripherally
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15
Q

are adenomatoid odontogenic tumors symptomatic or asymptomatic? how are they discovered?

A

asymptomatic and discovered during xray to determine why a tooth hasn’t erupted

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16
Q

describe the radiographic features of adenomatoid odontogenic tumors

A
  • 75% - tumor is circumscribed, unilocular RL involving the crown of an unerupted tooth
    • most often canine
  • RL often extends apically past the CEJ (helps differentiate from dentigerous cyst)
  • lesion may contain fine, snowflake calcifications (can also help differentiate from dentigerous cyst)
  • lesion may develop well-defined, unilocular RL between roots
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17
Q

what is the treatment of adenomatoid odontogenic tumors?

A

tumor has a thick, fibrous capsule that makes enucleation easy

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18
Q

what is the recurrence and prognosis for adenomatoid odontogenic tumors?

A
  • recurrence doens’t occur - lesion is completely benign, and aggressive behavior ahs not been documented
  • prognosis is good
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19
Q
A

adenomatoid odontogenic tumor

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20
Q
A

adenomatoid odontogenic tumor

(you can see the snowflake calcifications)

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21
Q
A

adenomatoid odontogenic tumor

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22
Q

calcifying epithelial odontogenic tumors are also called ___

A

pindborg tumors

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23
Q

calcifying epithelial odontogenic tumors occur around age ___

A

40

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24
Q

what is the common location of calcifying epithelial odontogenic tumors? genetic predilection?

A
  • posterior mandible
  • M=F
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25
Q

what is the most common presenting sign of calcifying epithelial odontogenic tumors?

A

painless, slow-growing swelling

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26
Q

what are the radiographic features of calcifying epithelial odontogenic tumors?

A
  • unilocular or multilocular - unilocular more common in maxilla
  • margins are typically scalloped and well-defined; may be corticated or ill-defined
  • contains calcified structures of varying size and density
    • some believe the calcifications are prominent around the crown in a “driven-snow” pattern
    • occurs in 10%
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27
Q

calcifying epithelial odontogenic tumors are frequently associated with a ___

A

impacted tooth (most often a mandibular molar)

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28
Q

what are the histopathologic features of calcified epithelial odontogenic tumors?

A
  • nuclear pleomorphism and atypia
  • amyloid-like extracellular materia; positive for congo red, which exhibits an apple-green birefringence when viewed under polarized light
  • calcifications with concentric rings form in the amyloid-like areas (Liesegang rings)
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29
Q
A

adenomatoid odontogenic tumor

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30
Q

what is the treatment of calcifying epithelial odontogenic tumors? what is the recurrence and prognosis?

A
  • local resection with a narrow rim of bone is the treatment of choice
  • 15% recurrence; highest with curettage as treatment
  • prognosis is typically good, but rare lesions can exhibit aggressive or malignant behavior
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31
Q
A

calcifying epithelial odontogenic tumor

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32
Q
A

calcifying epithelial odontogenic tumor

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33
Q
A

calcifying epithelial odontogenic tumor

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34
Q

___ is a true mixed tumor - both epithelial and mesenchymal tissues are neoplastic

A

ameloblastic fibroma

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35
Q

ameloblastic fibromas typically occur in what age patient?

A

occurs in younger patients - usually before age 20

36
Q

are ameloblastic fibromas symptomatic or asymptomatic?

A
  • small tumors are asymptomatic
  • largers ones cause painless swelling
37
Q

70% of ameloblastic fibromas are located in the ___

A

posterior mandible

38
Q

what are the radiographic features of ameloblastic fibromas?

A
  • can be unilocular or multilocular
  • margins are well-defined and sclerotic
  • 75% are associated with an unerupted tooth
39
Q

what is the treatment of ameloblastic fibroma?

A
  • conservative initial therapy; recurrences requrie more aggressive surgery
    • 50% of ameloblastic fibrosarcomas develop in the setting of a recurrent ameloblastic fibroma
40
Q

50% of ___ develop in the setting of a recurrent ameloblastic fibroma

A

ameloblastic fibrosarcomas

41
Q
A

ameloblastic fibroma

42
Q

___ histologically appears similar to ameloblastic fibroma, except it also has enamel and dentin

A

ameloblastic fibro-odontoma

43
Q

what is the average age patient with an ameloblastic fibro-odontoma?

A

10 years old

44
Q

what is the most common locations of ameloblastic fibro-odontomas?

A

posterior jaws

45
Q

are ameloblastic fibro-odontomas symptomatic or asymptomatic?

A

small tumors are asymptomatic; larger ones are associated with a painless swelling

46
Q

what are the radiographic features of ameloblastic fibro-odontomas?

A
  • well-circumscribed unilocular RL
  • contains varying amounts of calcified material
  • typicaly associated with an unerupted tooth
47
Q

what is the treatment of ameloblastic fibro-odontomas? what is the recurrence?

A

conservative curettage with rare recurrence

48
Q
A

ameloblastic fibro-odontoma

49
Q
A

ameloblastic fibro-odontoma

50
Q

___ is the malignant counterpart of the ameloblastic fibroma

A

ameloblastic fibrosarcoma

51
Q

ameloblastic fibrosarcomas typically show features of malignancy on what portion of the lesion?

A

mesenchymal

52
Q

what is the average age and gender predilection of ameloblastic fibrosarcomas?

A
  • M>F
  • average age is 25-30
53
Q

80% of ameloblastic fibrosarcomas occur in the ___

A

mandible

54
Q

patients with ameloblastic fibrosarcomas often complain of ___ and ___

A

pain and swelling

55
Q

what is the radiographic presentation of ameloblastic fibrosarcoma?

A

ill-defined, destructive RL lesion

56
Q

what is the treatment for ameloblastic fibrosarcoma? what % of patients will succomb to disease?

A
  • radical surgical excision
  • 20% will succomb to disease, usually due to uncontrolled local growth
57
Q
A

ameloblastic fibrosarcoma

58
Q

___ is the most common odontogenic tumor, and is considered to be a developmental anomaly (hamartoma) rather than a true neoplasm

A

odontoma

59
Q

odontomas are divided into what two types?

A

compound and complex

60
Q

which type of odontoma is composed of multiple, small, toothlike structures?

A

compound

61
Q

which odontoma type is a conglomerate mass of enamel and dentin; bears no anatomic resemblance of a tooth

A

complex

62
Q

what is the average age of someone with an odontoma?

A

15

63
Q

are odontomas symptomatic or asymptomatic?

A

completely asymptomatic

64
Q

how are odontomas typically discovered?

A

they are rarely small and discovered via xray when films are taken to determine the reason for failure of an unerupted tooth

65
Q

odontomas are typically associated with a ___

A

unerupted tooth

66
Q

compound odontomas are more common in what location? what about complex odontomas?

A
  • compound - anterior maxilla
  • complex - molar regions
67
Q

how do compound odontomas appear radiographically?

A
  • appears as a collection of toothlike structures of varying size and shape
  • surrounded by a narrow RL zone
68
Q

how do complex odontomas appear radiographically?

A
  • calcified mass with the radiodensity of a tooth
  • surrounded by a narrow RL rim
69
Q

are radiographic findings usually diagnostic for compound and complex odontomas?

A

yes

70
Q

what is the treatment of odontomas? what is the prognosis?

A

simple local excision with excellent prognosis

71
Q
A

compound odontoma

72
Q
A

compound odontoma

73
Q
A

compound odontoma

74
Q
A

complex odontoma

75
Q
A

complex odontoma

76
Q

what is the differential for a radiographic presentation of soemthign that is RL with calcifying RO?

A
  • calcifying odontogenic cyst
  • adenomatoid odontogenic tumor
  • calcifying eptihelial odontogenic tumor
  • ameloblastic fibro-odontoma
77
Q

odontogenic myxomas only occur in ___

A

the jaws

78
Q

odontogenic myxomas are commonly found in patients of what age? gender predilection?

A

ages 25-30

M=F

79
Q

are odontogenic myxomas more common in the maxilla or mandible?

A

mandible

80
Q

are odontogenic myxomas symptomatic or asymptomatic?

A
  • small lesions are asymptomatic
  • large lesions are associated with a painless expansion of bone
81
Q

what is the radiographic presentation of odontogenic myxomas?

A
  • unilocular or multilocular RL - may displace or cause resorption of teeth
  • RL defect may contain thin, wispy trabeculae of residual bone, which are often arranged at right angles to one another
82
Q

what is the treatment of odontogenic myxomas?

A
  • small myxomas - curettage with careful periodic re-evaluation every 5 years
  • larger lesions - more extensive resection because they tend to infiltrate the surrounding bone
83
Q

what is the recurrence and prognosis of odontogenic myxomas?

A
  • recurrence 25%
  • prognosis is good
84
Q
A

odontogenic myxoma

85
Q
A

odontogenic myxoma

86
Q
A

odontogenic myxoma

87
Q
A

odontogenic myxoma

Dr. Murrahs class (17 decks)

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