Connective Tissue Lesions Flashcards
Most common benign tumor of the oral cavity
Fibroma
Fibroma also called
Irritation fibroma
Traumatic fibroma
Most common site for fibroma
Buccal mucosa near the occlusal plane - cheek biting
Labial mucosa
Tongue
Gingiva
Denture induce fibrous hyperplasia of oral mucosa related to the chronic trauma produced by an ill fitting denture
Denture fissuratum
Denture epulis
Common site for denture epulis
Facial aspect of alveolar ridge
Difference between peripheral fibroma and fibroma
Fibroma is seen in buccal mucosa and tongue commonly
Peripheral is commonly seen on gingiva
Reactive gingival growth identical to peripheral fibroma but contains calcified islands within the fibrous tissue
Peripheral ossifying fibroma
Firm slow growing sessile gingival mass covered by normal appearing mucosa commonly found on the facial gingiva of mandible containing stands of ODONTOGENIC epi within the CT
Peripheral odontogenic fibroma
Drugs contributing in gingival hyperplasia
Phenytoin
Cyclosporin
Nifedipine
Diltiazem
Amlodipine
Verapamil
Benign vascular smooth muscle tumor
Leiomyoma
Intraoral sites for leiomyoma
Lips
Tongue
Palate
Cheek
Malignant neoplasm of smooth muscle, presents as enlarging ulcerated mass that may or may not be painful intraorally
Leiomyosarcoma
Granular cell tumor also known as
Granular cell myoblastoma
Intraoral site for granular cell tumor/myoblastoma
Dorsal surface of the tongue
Buccal mucosa
Age predilection in granular cell tumor
Female
4th to 6th decade of life
Granular cell tumor may be mistaken for SCC because
Pseudo epitheliumatous hyperplasia of the overlying oral epi specially on the tongue
Soft tissue tumor in on the max alveolar ridge of newborn females
Congenital epulis of newborn
Autoimmune disease involving deposition of large amounts of dense collagen 1 and 3
Systemic sclerosis
Scleroderma
Features of scleroderma
Females
30-50 yrs of age
2 forms
Limited - no internal organs involved
Diffuse - skin along with heart kidney BB joints etc involved
Pulmonary fibrosis - Leading to pulmonary hypertension and HF
Smooth mask like face, fibrosis of fingers claw like fingers
Atrophic nasal alae
Pinched app giving MOUSE FACE LOOKS
Scleroderma
Systemic sclerosis
Oral manifestations of systemic sclerosis
Microstomia
Trismus
Purse string app
Dysphagia
Xerostomia
Firm hypomobile tongue
Loss of attached gingiva
Recession
Diffuse widening of PDL
Mand resorption
Generalised widening of PDL
Bilateral resorption of Condyles
Systemic sclerosis
Common intraoral site for lipoma
Buccal mucosa
Buccal vestibule
Tongue
Floor of the mouth
Traumatic neuroma
Reactive proliferation after nerve damage
Trauma to peripheral nerve
Smooth surface non ulcerated nodules usually seen in the mental foramen area
Tongue
Lower lip with a history of trauma (extraction) followed by tenderness with digital pressure
Traumatic neuroma
Benign neoplasm derived from a proliferation of SCHWANN cells of nerve sheath
Schwannoma (neurilemmoma)
Features of schwannoma
Found in young adults
Common site dorsal surface of tongue
Slow growing encapsulated asymptomatic submucosal mass
Pushes the nerve aside
Microscopic patterns of schwannoma
Antoni A - spindle cells organised in palisaded pattern around acellular eosinophillic zones called VEROCAY BODIES
Antoni B: spindle cells haphazardly distributed in a delicate fibrillar microcytic matrix
Most common benign peripheral nerve neoplasm
Neurofibroma
Neurofibroma originates from?
Schwann cells
Perineural fibroblasts
Presentation of neurofibroma
Solitary lesions
Multiple lesions in neurofibromatosis type 1
Neurofibromatosis 1 also knows as
Von recklinghausen’s disease of skin
Features of solitary neurofibroma
Common in young adults
Slow growing painless soft lesions
Small nodules to large mass
Tongue and buccal mucosa
Features of neurofibromatosis type 1
Inherited autosomal dominant associated with multiple neurofibromas of the OC and skin
Cafe au lait spots
Iris freckling - lisch nodules
Axillary freckling
Crowe sign
Lisch nodules present in
Neurofibromatosis type 1
Von recklinghausens disease of skin
Which gene is involved in neurofibromatosis type 1
NF1 gene
Most common type if neurofibromatosis
Vin recklinghausens disease of skin - neurofibromatosis type 1
Systemic complications of neurofibromatosis type 1
Hypertension
Pheochromocytoma
CNS tumors
Mental deficiency
Seizures
intraoral manifestations involved in von recklinghausens disease of skin
Enlargement of fungiform papillae
Resulting in tongue enlargement
Unilocular or multilocular radiolucencies
Enlargement of mand foramen, mand canal
Increased bone density
Increased coronoid notch dimension
Neurofibromatosis type 1 may be associated with
Malignant transformation- neurofibrosarcoma
Or
Malignant schwannoma
Rare inherited disorder characterized by tumkrs or hyperplasia of neuroendocrine tissues
Multiple endocrine neoplasia MEN syndrome
Types MEN syndrome
MEN 1: tumor hyperplasia of pulmonary gland, parathyroid gland, pancrease and adrenal cortex
MEN 2: subtype 2A sipple syndrome - parathyroid hyperplasia or adenoma
Medillary CA of thyroid, pheochromocytoma of the adrenal medulla
Pancreas not involved
MEN 3: subtype men 2B-
Which type of MEN has oral manifestation
MEN 3
Oral manifestations of MEN type 3
Mucucutaneous neuromas
Oral mucosal neuromas - asymptomatic nodules on the lips, ant tongue, buccal mucosa, gingiva and palate
Patient presented with multiple asymptomatic nodules in lips and tongue
oral mucosal neuromas in MEN 3
What is the significance of removing thyroid gland as a prophylactic treatment in MEN 3
High risk of medullary carcinoma of the thyroid
Benign hamartomas of the lymphatic vessels develops on the skin and MM
Lymphangioma
Intraoral site for lymphangioma
Ant 2/3rd of the tongue resulting in macroglossia
Presents as soft fluctuant nodules or vesicles with pebbly surface ranging in colour from pink to blue
Types of lymphangioma
Macrocytic : cyst like spaces 2cm or more in diameter - CYSTIC HYGROMA - In the neck involving vital structures
Microcytic: vascular channels of less than 2cm in diameter
MIXED: combi of macro and micro
Which type of lymphangioma is common in oral cavity
MICROCYSTIC
Benign reactive proliferation of the superficial fascia - fibroblasts in young adults presents as rapidly growing firm mass pain and tenderness
Nodular fascitis
Common intraoral site for nodular fascitis
Buccal mucosa
Group of locally aggressive fibrous proliferation that show infiltrative destructive and recurrent growth but no tendency to metastasize
Fibromatosis
Common intraoral site for fibromatosis
Paramandibular soft tissues Of children and young adults
