Cysts and Odontogenic Tumors Part 2 Flashcards
where is the globulomaxillary position
at the junction of the maxilla with premaxilla, between maxillary lateral incisor and canine
is there a developmental fissural cyst in the globulomaxillary position
no
a developmental “globulomaxillary cyst”:
does not exist
what cysts are found in the globulomaxillary position and what is the prevalence of each
- PA cyst: 50%
- PA granuloma: 15%
- lateral periodontal cyst: 10%
- odontogenic keratocyst: 10%
- giant cell tumor: 7%
- other lesions: 3% such as gorlin cyst, odontogenic myxoma, adenomatoid odontogenic tumor, neurofibroma, hemangioma
what are the dental lamina cysts
- lateral periodontal cysts
- botryoid odontogenic cyst
- gingiva cyst of adult
- dental lamina cyst of newborn
describe the lateral periodontal cyst and its prevalance
- a developmental cyst that arises from dental lamina rests (rests of Serres)
- vital teeth of adult males (3:1)
- mandibular premolar area
- maxillary incisor-canine area
- unilocular
what is the DDX for lateral periodontal cyst
PA cyst
what is the tx for lateral periodontal cyst
surgery
what is the histological presentation for lateral periodontal cyst
- epithelium, lumen, wall
- epithelium alternates thick and thin areas
describe the botyroid odontogenic cyst
- polycystic variant of the lateral periodontal cyst
- a developmental odontogenic cyst that presents as a multilocular lucency associated with the vital mandibular premolars of adults
describe the gingival cyst of the adult and the prevalance
- soft tissue counterpart of the lateral periodontal cyst
- no radiographic presenation
- a developmental cyst that arises from dental lamina rests (rests of Serres)
- vital teeth of adult males (3:1)
- mandibular premolar area and. maxillary incisor-canine area
what is the histological presentation of gingival cyst of the adult
alternating thick and thin epithelium
what is the tx for the dental lamina cyst of the newborn
will usually resolve on their own
what is the histological presentation of the dental lamina cyst of the newborn
mutliple cystic areas filled with keratin
what are the other names for the palatal cyst of the newborn
- epstein’s pearls
- Bohn’s nodule
describe dental lamina cysts
- epithelial remnants of dental lamina from odontogenesis
- odontogenic cysts
describe epstein’s pearls
- epithelial remnants from palatal shelf fusion
- non-odontogenic cysts
describe Bohn’s nodules
- epithelial remnants from minor salivary gland formation
- non-odontogenic cysts
describe primordial cysts
- radiographic dx only
- radiographic term for a cyst that develops in place of a tooth
- likely to be an OKC
- found in an area of a congenitally missing tooth
what is the DDX for primordial cyst
residual cyst
describe OKCs
- posterior jaws of teenagers, young adults
- aggressive growth with 30% recurrence
- a unilocular or multilocular radiolucency; imitates other lucencies
what are the radiographic presentations of OKCs and the prevelance of each
- primordial cysts: 50%
- lateral periodontal: 25%
- dentigerous: 10%
- globulomaxillary:10%
what is the histology for an odontogenic keratocyst
- compact epithelium, no rete ridges, 8 to 10 cell layers thick
- corrugated surface parakeratin
- prominent, palisaded, hyperchromatic basal layer
what is the histologic presentation of an OKC
- epithelium is thin
- basal cell layer is really dark
- keratin is wavy
what is the significance of the odontogenic keratocyst
- aggressive behavior
- recurrence- 30%
- nevoid basal cell carcinoma syndrome
what is the cause of non-syndrome associated OKC
idiopathic
what is the cause of syndrome associated OKC
multiple OKCs common in the nevoid basal cell carcinoma syndrome
what is the other name for nevoid basal cell carcinoma syndrome
gorlin syndrome
describe nevoid basal cell carcinoma syndrome
- basal cell nevus syndrome
- gorling-goltz syndrome
- gorlin syndrome
- autosomal dominant- highly penetrant and variably expressive
- mutation in PTCH tumor suppressor gene at 9q22.3
what are the features of the nevoid basal cell carcinoma syndrome
- skeletal anomalies: bifid ribs
- jaw cysts: multiple OKCs
- skin tumors: multiple, early onset, basal cell carcinomas
- neoplasms- CNS- medulloblastoma
when do multiple basal cell carcinomas in nevoid basal cell carcinoma syndrome occur
early in life
what should you do in early recognition and dx of nevoid basal cell carcinoma syndrome
- OKCs present early
- prevent disfiguring basal cell carcinomas
- evaluate for medulloblastoma
describe the orthokeratinizing odontogenic cyst
- a developmental odontogenic cyst with an orthokeratin lining, NOT parakeratin
- originally described as the “orthokeratinized variant of the odontogenic keratocyst”
- does not behave as an odontogenic keratocyst- no recurrence
what is the difference between histology of OKC and OOC
- OKC is wavy and palisading
- OOC is not wavy and not palisading
describe the calcifying odontogenic cyst (Gorlin cyst)
- gorlin cyst, calcifying and keratinizing odontogenic cyst
- anterior jaws of adults
- radiolucent to mixed
- ghost cells
- sometimes associated with odontomas
describe the glandular odontogenic cyst
-sialodontogenic cyst- an odontogenic cyst with glandular (salivary) features
- anterior jaws of middle aged adults, mandible > maxilla
- commonly multilocular, crosses midline
- aggressive behavior - 30% recurrence
