Chapter 7 Flashcards
Neoplasia
“New growth”
Cells exhibit uncontrolled proliferation, resulting in a mass of abnormal cells
Tumor
Swelling /enlargement of tissues
Synonym for “neoplasia”
Oncology
Study of tumors or neoplasms
Oncogenic virus : causes cancer
Other causes : chemicals (carcinogens), radiation, genetics,unknown
Carcinoma
Malignant tumor (cancer) of epithelium
Sarcoma
Malignant tumor (cancer) of CT or NON-epithelial tissues
Leukoplakia
White, plaque like lesion in oral mucosa, unknown cause, cannot be wiped away, hyperkeratosis,
10% may be malignant or pre malignant
Erythroplakia
Red lesion
MORE serious that a white lesion
Less common in oral cavity than leukoplakia (60 white : 1 red)
Metaplasia
Change in cells from normal to abnormal
Anaplasia
Change in cells to an immature or undifferentiated state
Characteristic of malignant cancerous tumors
Ex. White blood cells that no longer do their job of fighting infection, they’ve digressed into undifferentiated cells. Characteristic sign of leukemia
Dysplasia
Disordered growth
Alteration in size, shape, and organization of adult cells
Epithelial dysplasia
Dysplasia of epithelium
Carcinoma in situ
MOST severe epithelial dysplasia involving the full thickness of epithelium (low metastasis since epithelium has no blood vessels)
NO invasion of underlying CT (basement membrane)
Benign tumors
Localized Encapsulated (well circumscribed) Slower growing Rare or no mitotic figures Well differentiated / resemble normal cells
Malignant tumors (cancer)
Invades/spreads (metastasis)
Diffuse borders
Rapid growth
Mitotic figures (dividing cells in process of mitosis)
Poorly to well differentiated, changed cells
No “Contact inhibition” (normal cells stop dividing once they hit other cells, malignant cells don’t stop dividing even when hitting other cells)
Epithelial tumors
Papilloma
Squamous cell carcinoma
Verrucous carcinoma
Basal cell carcinoma
Salivary gland tumors
Adenoma (pleomorphic adenoma)
Adenocarcinoma (adenoid cystic carcinoma, mucoepidermoid carcinoma)
Odontogenic tumors
Ameloblastoma
Cementoblastoma
Odontoma (compound/complex)
Soft tissue tumors
Lipoma Neurofibroma Schwannoma Granular cell tumor Congenital epulis Rhabdomyoma, rhabdomyocarcoma Leiomyoma, leiomyosarcoma
Squamous cell carcinoma
Most common cancer of the oral cavity
Aka - Epidermoid carcinoma
Most commonly found on the posterior lateral borders of tongue and floor of the mouth
Vascular tumors
Hemangioma
Lymphangioma
Kaposis sarcoma
Melonatic tumors
Melanocytic nevus (nevi -plural) Malignant melanoma
Bone and cartilage tumors
Torus Exostosis Osteoma Osteosarcoma Chondroma Chondrosarcoma
Blood and blood-forming tissue tumors
Leukemia
Lymphoma
Multiple myeloma
Papilloma
Epithelial tumor- best prognosis
Benign tumor of squamous epithelium
Finger like projections, looks like cauliflower
Keratotic
Excision for treatment - one pudgy had but cured with homeopath
Squamous cell carcinoma
Epidermoid carcinoma epithelial tumor
Most common malignancy of oral cavity
Clinically looks like ulcerative mass, white, red, bleeding
Invades through basement membrane and into CT
May have keratin pearls
RISK factors: tobacco, sun, alcohol, HPV
Prono sis depends on metastitis of tumor
Verrucous carcinoma
Less invasive, slower growing cancer that does not cross the basement membrane
Epithelial tumor
Pebbly red white kerotic surface
Does not usually metastisize
Basal cell carcinoma
Malignant skin tumor of epithelium, associated with sun exposure, not found in oral cavity
Non healing ulcer on skin with rolled borders
Prognosis is better than squamous cell carcinoma, locally invasive, rarely metastisizes
Surgical excision
Pleomorphic adenoma
Salivary gland tumor
Benign salivary gland tumor
Most common salivary gland tumor
Contains both epithelial and CT (mixed tumor)
Common sites: parotid (extraorally) and palate (intraorally)
Slow growing, painless, dome shaped
Adenocarcinoma
Malignant tumors of salivary glands
Adenoid cystic carcinoma, mucoepidermoid carcinoma
Parotid gland and palate
Slowly enlarging mass, may be painful
Prognosis : good/fair if no metastisis, poor if metastisis (spread to lymph nodes)
Ameloblastoma
Odontogenic tumor
Benign slow growing but locally invasive odontogenic tumor
Most common (80%) in mandible (molar/ramus)
Expansion of bone, slow developing, asymptomatic, swelling
Causes extensive damage because of its invasion
Multilocular soap bubble radiolucency
Surgical excision but frequent recurrence
Periapical cemento-osseous
Bone lesion of unknown cause usually in anterior mandible, 30 year and over black women.
Asymptomatic
Composed of calcifications (may resemble bone, cementum or both) and fibrous tissue making it fibro-osseous
Well circumscribed and radiolucent, mimicking periapical inflam
Early lesions are mostly fibrous, later are more calcified
Pagents disease
AKA - Osteitis deformans or Leontiasis ossea
Chronic metabolism bone disease - resorption, osteoblastic repair, and demineralization.
Involves pelvis, spinal column, maxilla causing enlargement of bone and pain. Can cause spacing of teeth because of extra bone growth and hypercementosis
Men over 50 w virus cause suspected
Patchy radiolucent and radiopacent, “cotton wool appearance”
Elevated alkaline phosphatase levels, mosaic bone, obliterated PDL, no lamina dura, fractures and tumors may occur
Osteomalacia
Develops over a long period of time because of calcium deficiency
Delayed tooth eruption and perio disease
Pathological fractures and changes in bone trabeculation
Related to Rickets in children
Vitamin D deficiency
May be induced by tumors, malabsorption, drugs, liver/kidney disease, chronic use of antacids
Cementoblastoma
Odontogenic tumor
Benign, painful cementum producing lesion fused to tooth root
Week defined, radiopaque mass contiguous w tooth root
Obliterate tooth root and cause bone expansion
Trxt: removal (enulceation) of tumor and tooth
Odontoma
MOST COMMON odontogenic tumor
Benign tumor composed of enamel, dentin, cementum, pulp
Mostly young adults
COMPOUND- cluster of many small teeth sourrounded by radiolucent halo
COMPLEX- radiopaque mass of tooth tissue but not tooth, sourrounded by radiolucent halo
Lipoma
Soft tissue tumor
Benign tumor of fat cells
Yellow mass covered by thin epithelium, delicate pattern of blood vessels on the surface of fat
Neurofibroma/Schwannoma (neurolemmoma)
Benign soft tissue tumor derived from nerve tissue
From Schwann cells (CT surrounding nerves)
TONGUE is most common site
Associated with Von Recklinghausen disease with cafe au late spots
Granular cell tumor
Soft tissue benign tumor composed of large cells w granular cytoplasm
Tongue is most common introral site
Congenital epulis
Soft tissue benign tumor aka congenital epulis of newborn
Usually sessile or pedunculated mass on gingiva
Most common on anterior maxillary gingiva of girls
Rhabdomyoma
Benign tumor of striated muscle, tongue is most common site
Rhabdomyosarcoma
MALIGNANT tumor of striated muscle
Most common malignant soft tissue tumor of H&N in kids
Very aggressive tumor with poor prognosis
Leiomyoma
Benign tumor of smooth muscle
Leiomysarcoma
Malignant tumor of smooth muscle
Hemangioma
Vascular tumors Benign proliferation of capillaries Common developmental abnormality lesion Birthmark, but mat shrink or enlarge over time Injection of sclerosing solution to fix
Lymphangioma
Benign vascular tumor composed of lymphatic vessels, present at birth
Tongue is most common intraoral site, may lead to macroglossia
Kaposis sarcoma
Malignant vascular tumor
Aggressive form in HIV patients
Purplish tumor of hard palate and gingiva most common
Human herpes 8
Melanocytic nevus (nevi plural)
BENIGN melanotic tumor of melanocytes
Intraoral nevi are tan brown purple papules macules
Most common on hard palate, then buccal mucosa
Malignant melanoma
Malignant tumor of melanocytes- all melanomas are malignant
On skin from sun exposure
Rare in oral cavity but may metastisize from skin to oral cavity
Rapidly enlarging to blueish black mass
Palate and maxillary palate
Very aggressive, poor prognosis
Torus
Bone and cartilage tumors
Benign, normal
Osteoma
Benign, tumor of mature bone, asymptomatic
Slow growing, sharply defined, radiopaque area
Bone expansion
Associated with Gardner syndrome
Surgical excision
Osteosarcoma
Malignant tumor of bone forming tissue
Most common primary malignant tumor of bone under 40 yr old
Diffuse painful swelling
Parasthesia of lip
Variable radiographic appearance, sunburst pattern
Poor prognosis
Chondroma
Cartilage tumor. Benign
Chondrosarcoma
Malignant cartilage tumor
Chemotherapy/radiation is not effective
