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OSOMOP > Disease of the Bone - Tumour-Like and Neoplastic > Flashcards

Disease of the Bone - Tumour-Like and Neoplastic Flashcards

1
Q

What is a torus?

A

Tumour like mass of bone occurring in precise anatomical locations in the jaw

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2
Q

Describe the classification of torus

A
  1. Torus palatinus (hard palate)

2. Torus mandibularis (mandible)

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3
Q

Describe the general features of tori

A
  • Relatively common
  • Appears in young adult life
  • Both sexes affected
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4
Q

Describe the clinical features of torus palatinus

A
  • Bony hard swelling in bilaterally in the vault of hard palate in the midline, may be lobulated
  • Normal overlying mucosa present
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5
Q

Describe the clinical features of torus mandibularis

A
  • Bony hard swelling bilaterally in premolar region of mandible on lingual aspect, may be lobulated
  • Normal overlying mucosa present
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6
Q

Describe the radiographic features of tori

A
  • Non-specific

- Facial views may show radiodense mass in characteristic location

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7
Q

Describe the pathology of tori

A
  • Mass of dense sclerotic lamellar bone
  • May have trabecular arrangement with fibrous intertrabecular tissue
  • Not normally biopsied
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8
Q

Describe the treatment of tori

A
  • Usually unnecessary
  • Reassure the patient
  • Surgical reduction may be required to allow fit of dentures
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9
Q

What is fibrous dysplasia?

A

A benign condition, presumably developmental in nature, characterised by presence of fibrous connective tissue with irregular trabeculae of bone

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10
Q

Describe 3 classifications of fibrous dysplasia

A
  1. Monostotic (one bone - 75%)
  2. Polyostotic (many bones - 25%)
  3. Albright’s Syndrome (rare)
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11
Q

Describe the general features of fibrous dysplasia

A
  • Young patients, childhood or adolescence
  • 3F : M
  • Any bone, frequently maxilla
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12
Q

Describe HPC of fibrous dysplasia

A
  • May be incidental

- Slow progressive enlargement of bone with deformity

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13
Q

Describe clinical features of fibrous dysplasia

A
  • Painless swelling of bone with deformity

- May cause malocclusion, spacing of teeth or nerve or ocular compression

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14
Q

Describe the radiographic appearance of fibrous dysplasia in terms of extent, quality, margins and adjacent anatomy

A

Extent: Usually large area or all of bone
Quality: Variable, “ground glass” or “cystic” appearance
Margins: Ill-defined
Adjacent Anatomy: May obliterate antrum, compress nerve, separate teeth

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15
Q

Describe the pathology of fibrous dysplasia

A
  • Variable pathology
  • Fibro-osseous
  • Irregular short trabecular of bone, often woven bone, in a vascular fibrous stroma
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16
Q

Describe the treatment of fibrous dysplasia

A
  • None usually
  • Surgery may be required
  • Regrowth can occur
  • Bisphosphonates
  • May regress as the patient reaches adulthood
17
Q

Describe the prognosis of a patient suffering from fibrous dysplasia

A
  • Persistent residual deformity common

- Sarcomas recorded usually following radiotherapy

18
Q

What is Paget’s disease?

A

A progressive disorder representing a disturbance of the “coupling” off synthesis and resorption of bone

19
Q

What is another name for Paget’s disease?

A

Osteitis deformans

20
Q

Describe the classification of Paget’s disease

A
  1. Monostotic (15%)

2. Polyostotic (85%)

21
Q

Describe the general features of Paget’s disease

A
  • 4% over 40 years, becoming commoner with age
  • 2M:F
  • Any bone, frequently jaws and usually maxilla
22
Q

Describe the HPC of Paget’s disease

A
  • May be incidental

- Slow progressive enlargement of bone with deformity, occasionally painful

23
Q

Describe the clinical features of Paget’s disease

A
  • Enlargement of skull and jaws
  • Swelling with deformity, weight bearing, bowing of legs and spinal curvature
  • Red and warm skin
  • Usually maxilla (80% bilateral)
  • Neurological effects if skull base affected
24
Q

Describe the radiographic features of Paget’s disease in terms of extent, quality, margins and adjacent anatomy

A

Extent: Usually large area or all of bone
Quality: Variable, initially radiolucent then radiopaque (cotton wool)
Margins: Ill-defined
Adjacent Anatomy: Teeth displaced, resorbed, ankylosed

25
Q

Describe the pathology of Paget’s disease

A
  • Variable
  • Fibro-osseous
  • Irregular masses of lamellar bone with prominent reversal lines, giving mosaic pattern
  • Fibrous stroma
  • Osteoblastic and osteoclastic activity
26
Q

Describe the pathology in teeth of Paget’s disease

A
  • Resorption, hypercementosis and ankylosis may affect roots in adjacent teeth
27
Q

Describe 4 treatments for Paget’s disease

A
  1. Specialist referral
  2. Analgesia
  3. Calcitonin
  4. Bisphosphonates
28
Q

Describe 4 complications of Paget’s disease

A
  1. Difficult extraction
  2. Pathological fracture
  3. Infection and osteomyelitis
  4. Sarcoma
29
Q

Give an overview of neoplasms of the bone

A
  • Neoplasms off the bone are uncommon
  • Classification and nomenclature are complex
  • Diagnosis based on careful correlation of clinical, radiology and histopathology
30
Q

Describe the classification of neoplasms of the bone

A
  1. Benign

2. Malignant - Primary, Haemopoietic and Secondary

31
Q

Describe 4 general features of neoplasms of the bone

A
  1. Rare in jaw bones
  2. Wide age range with both sexes affected
  3. May present with non-specific symptoms apparently related to odontogenic apparatus
  4. Requires specialist referral for investigation and management
32
Q

Describe the clinical features of neoplasms of the bone

A
  • Variable
  • Bone pain and swelling
  • Tooth mobility
  • Pathological fracture
  • Paraesthesia
33
Q

Describe the radiographic features of the neoplasms of the bone

A
  • Variable
  • Radiolucency
  • Speckled radiolucency
  • Radiodensity
  • Changes in associated anatomical markings or structures
34
Q

Describe the pathology of neoplasms of the bone

A
  • Bone / Cartilage / Fibrous tissue
  • Haemopoietic elements
  • Osteoclastic giant cells
  • Decalcification of specimen required before examination of sections

OSOMOP (14 decks)

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