E2: Benign tumors of the jaws Flashcards

1
Q

What is the definition of a benign tumor?

A
  • Any swelling
  • One of the four signs of inflammation: calor, dolor, rubor, and tumor
  • Neoplasm
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2
Q

What are the 4 signs of inflammation?

A

calor, dolor, rubor, and tumor

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3
Q

What are the different broad types of neoplasm?

A

benign and malignant

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4
Q

What is the definition of benign?

A

a neoplasm that does not spread to remote parts of the body (metastasis) and does not invade adjacent normal tissues

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5
Q

What is the definition of malignant?

A

invades surrounding tissues, may metastasize to other sites, and are likely to recur, and may be fatal to the patient

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6
Q

An abnormal tissue growth by cellular proliferation, usually a distinct mass of tissue is called a _____.

A

neoplasm

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7
Q

T/F: Growth of neoplasm is faster than normal and continues to grow even after the stimuli discontinues.

A

true

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8
Q

T/F: Neoplasms have partial or complete lack of structural organization and functional coordination with the normal tissue

A

true

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9
Q

What are the main characteristics of a benign tumor?

A
  • New growth of tissues, grows slowly
  • Spreads by direct extension
  • Histologically similar to native tissue
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10
Q

A _____ has limited growth, overgrowth of disorganized tissue

A

hamartoma

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11
Q

A ____ has organized growth

A

hyperplasia

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12
Q

What are the main imaging features of benign tumors?

A
  • Slow growing, therefore margins are smooth
  • Capsule around the lesion
  • Lucent to mixed content
  • Displaces tooth, canal, or cortex
  • Resorbs roots, perforates cortical bone
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13
Q

What are the main characteristics of torus palatinus?

A
  • Hyperostosis in the middle third of the hard palate
  • 20% of the population
  • Depends on race
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14
Q

What is the location, border and internal content of torus palatinus?

A
  • Location: On PA or pan, attached to and below the hard palate
  • Border: Well‐defined, corticated, lobulated
  • Internal content: Uniformly radiopaque
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15
Q
A

torus palatinus

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16
Q
A

torus palatinus

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17
Q

What are the main characteristics of torus mandibularis?

A
  • Lingual hyperostosis near the mandibular premolars
  • 8% of the population
  • Unilateral or bilateral
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18
Q

What is the location, border and internal content of torus mandibularis?

A
  • Location: Superimposed over cervical are of premolars, mostly bilateral
  • Border: Smooth, well defined, non corticated margin
  • Internal content: Uniformly radiopaque
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19
Q
A

torus mandibularis

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20
Q
A

hyperostosis (exostosis)

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21
Q

An ____ is the internal counterpart of exostosis

A

enostosis

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22
Q

What are the different synonyms for enostosis?

A

dense bone island
idiopathic osteosclerosis

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23
Q

What are the locations for enostosis?

A

Anywhere. Mandible> maxilla; premolar‐molar area

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24
Q

What is the periphery of enostosis described as?

A

Well‐defined, no lucent border, no cortication, sometimes blends

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25
Q

What is the content of an enostosis?

A

uniformly radiopaque

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26
Q

What are the effects of enostosis?

A
  • May resorb or displace roots
  • May wrap around IAC. Canal is not displaced or compressed
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27
Q
A

enostosis

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28
Q
A

enostosis

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29
Q

Differential Diagnosis of Enostosis

A

Sclerosing osteitis: associated with inflammation. The adjacent tooth is pulp exposed

Sialolith

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30
Q
A

sclerosing osteitis

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31
Q

Idiopathic osteosclerosis vs. sclerosing osteitis characteristics

A
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32
Q
A

sialolith

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33
Q

What are the clinical features of ameloblastoma?

A
  • Locally invasive, aggressive, yet benign
  • Malignant form of ameloblastoma
  • Multicystic or unicystic
  • Unicystic mural ameloblastoma arising from dentigerous cyst
  • Soft tissue ameloblastoma
  • More often in men, in African,
  • Average age: 40 years
  • Initially asymptomatic
  • Facial swelling: early sign
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34
Q

What are the imaging features of ameloblastoma?

A
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35
Q
A

ameloblastoma

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36
Q
A

ameloblastoma

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37
Q
A

ameloblastoma

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38
Q
A

ameloblastoma

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39
Q
A

ameloblastoma

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40
Q
A

ameloblastoma

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41
Q

What are the characteristics of recurrent ameloblastomas?

A
  • May recur after surgery - compartments appear thicker
  • Multiple cyst like appearance
  • May be separated with normal bone
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42
Q

What are the characteristics of calcifying epithelial odontogenic tumor?

A
  • Pindborg tumor
  • Rare, less aggressive than ameloblastoma
  • Has mineralized substance
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43
Q

What is the location of an calcifying epithelial odontogenic tumor?

A

Similar to ameloblastoma, mostly mandibular premolar‐molar
area, associated with an impacted tooth

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44
Q

What is the border of an calcifying epithelial odontogenic tumor?

A

Usually, well‐defined cyst‐like cortex

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45
Q

What is the internal structure of an calcifying epithelial odontogenic tumor?

A
  • Unilocular or multilocular
  • Many radiopacities, some near the crown of a tooth
  • Thin trabeculation may be present
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46
Q

What is the effect of an calcifying epithelial odontogenic tumor?

A
  • Displaces tooth, prevents eruption
  • Jaw expansion
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47
Q
A

calcifying epithelial odontogenic tumor

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48
Q
A

calcifying epithelial odontogenic tumor

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49
Q
A

calcifying epithelial odontogenic tumor

50
Q
A

calcifying epithelial odontogenic tumor

51
Q

What are the clinical features of adenomatoid odontogenic tumor?

A
  • Rare, non‐aggressive tumor
  • May contain dentinoid and enamel matrix
  • Follicular type: associated with crown of an impacted tooth
  • Extra‐follicular type: No tooth association
52
Q

What is the location of adenomatoid odontogenic tumor?

A
  • Mostly maxilla, incisor‐canine‐premolar region
  • Often associated with an impacted tooth, but not limited to the
    CEJ
53
Q

What is the border of adenomatoid odontogenic tumor?

A

Well‐defined, corticated

54
Q

What is the internal content of adenomatoid odontogenic tumor?

A

Some radiodense materials in some tumors. Others may be lucent

55
Q

What is the effect of adenomatoid odontogenic tumor?

A
  • Displacement of teeth
  • Root resorption rare
  • Some expansion, but cortex usually intact
56
Q
A

adenomatoid odontogenic tumor

57
Q

What are the clinical features of odontogenic myxoma?

A
  • Uncommon, benign, intraosseous lesions
  • Unilocular or multilocular
  • Nonencapsulated, infiltrates adjacent areas, but does not metastasize
  • Only in the jaws, hence termed odontogenic
58
Q

What is the location of odontogenic myxoma?

A
  • Mandible: Maxilla 3:1
  • In mandible, molar‐premolar area, rarely non‐tooth bearing area
  • In maxilla, alveolar process of molar‐premolar area
59
Q

What is the border of odontogenic myxoma?

A
  • In mandible, well defined
  • In maxilla, poorly defined
60
Q

What is the internal content of odontogenic myxoma?

A
  • Mixed appearance
  • Straight septa is the clue, but many septa are curved
61
Q

What is the effects of odontogenic myxoma?

A
  • Displaces and loosens teeth
  • Rarely resorbs roots
  • Some expansion
62
Q
A

Odontogenic Myxoma

63
Q
A

Odontogenic Myxoma

64
Q

What are the clinical features of cementoblastoma?

A
  • True Cementoma
  • Slow‐growing, mesenchymal tumor, mostly of cementum
  • Bulbous growth around the apex
  • Mostly with permanent teeth
  • Tooth is vital, but often painful
  • Mostly male
  • 12‐65 years, usually patient are young
65
Q

What is the location of cementoblastoma?

A

mostly mandible

66
Q

What is the border of cementoblastoma?

A

Well‐defined radiopacity, surrounded by radiolucent band, and then by
a corticated margin

67
Q

What is the internal content of cementoblastoma?

A
  • Mixed lesion, mostly radiodense
  • Root may not be visible
68
Q

What is the effect of cementoblastoma?

A
  • May cause root resorption
  • May expand bone, but no perforation
69
Q
A

benign cementoblastoma

70
Q

What are the clinical features of odontoma?

A
  • Compound and complex
  • Histologically, has mature enamel, dentin, cementum and pulp
  • Complex: No morphological similarity to a tooth
  • Compound: Similar to a tooth, may be small denticles
71
Q

What is the location of odontoma?

A

Compound frequently in anterior maxilla, complex frequently in mandible. Can be in either jaws.

72
Q

What is the border of odontoma?

A

Well‐defined, soft tissue band, corticated margins

73
Q

What is the internal content of odontoma?

A

Tooth‐like radiopaque structures

74
Q

What is the effect of odontoma?

A
  • Prevents eruption of normal teeth
  • Large odontomas may expand the jaws
  • Dentigerous cyst
75
Q
A

compound odontoma

76
Q
A

compound odontoma

77
Q
A

complex odontoma

78
Q

What are the clinical features of ameloblastic fibroma?

A
  • Soft odontoma
  • Benign mixed odontogenic tumor
79
Q

What is the location of ameloblastic fibroma?

A
  • Premolar‐molar area of mandible
  • Near alveolar crest, occlusal to an impacted tooth
80
Q

What is the border of ameloblastic fibroma?

A

Well‐defined, corticated

81
Q

What is the internal content of ameloblastic fibroma?

A

Unilocular: radiolucent. Multilocular: with septa

82
Q

What is the effect of ameloblastic fibroma?

A

Expands cortical plate, prevents eruption

83
Q
A

ameloblastic fibroma

84
Q
A

ameloblastic fibroma

  • Mixed internal content
  • Larger lesion has extensive calcifications
85
Q
A

Ameloblastic Fibro‐odontoma

86
Q

What are the clinical features of neurilemoma?

A
  • Schwannoma
  • Mandible a common site
  • Pain uncommon
87
Q

What is the location of neurilemoma?

A
  • Mandible: Maxilla 10:1
  • Within expanded inferior alveolar canal, or outside mental foramen
88
Q

What is the border of neurilemoma?

A

Well defined margin

89
Q

What is the internal structure of neurilemoma?

A

Radiolucent

90
Q

What is the effect of neurilemoma?

A
  • When near the foramen, enlarges it
  • Enlarges the canal
  • May resorb roots
91
Q

What are the clinical features of neurofibroma?

A
  • Moderately firm, benign, well‐defined tumors
  • When in mandibular canal, causes pain or paresthesia
92
Q

What is the location of neurofibroma?

A

In mandibular canal, cancellous bone, below periosteum

93
Q

What is the border of neurofibroma?

A

Sharp, corticated, fusiform lesion

94
Q

What is the internal content of neurofibroma?

A

Unilocular, rarely multilocular

95
Q

What is the effect of neurofibroma?

A

Expands, or perforates cortex

96
Q
A

neurofibroma

97
Q
A

neurofibroma

98
Q

Osteomas can be a ____ or _____.

A

benign tumor or hamartoma

99
Q

What are the three types of osteoma?

A

composed of cortical bone, cancellous bone or a combination of both

100
Q

T/F: Osteomas are external.

A

false (both external or internal)

101
Q

What is the location of osteomas?

A
  • Mandible> maxilla, usually posterior mandible
  • Paranasal sinuses, frontal sinus
102
Q

What is the border of osteomas?

A

well defined

103
Q

What is the internal content of osteomas?

A
  • Uniformly radiopaque
  • Cancellous type have trabeculation
104
Q

What is the effect of osteomas?

A

Displaces structures, dysfunction

105
Q
A

osteoma

106
Q
A

osteoma

107
Q

Which syndome has multiple osteoma, multiple enostosis, sebaceous cysts, multiple polyps of the intestines, and multiple unerupted supernumerary or permanent teeth?

A

Gardner’s syndrome

108
Q

What are the clinical features of central hemangiomas?

A
  • Proliferation of blood vessels, benign tumors, hamartoma
  • Any part of the body, but mostly on skin
  • Rare in jaws
109
Q

What is the location of central hemangioma?

A

Mandible > maxilla, posterior body of the mandible

110
Q

What is the border of central hemangioma?

A

Well or ill defined, may appear as a malignancy

111
Q

What is the internal content of central hemangioma?

A

May be multilocular

112
Q

What is the effect of central hemangioma?

A
  • Roots resorb
  • Enlargement of the canal
  • Early eruption
113
Q
A

central hemangioma

114
Q
A

central hemangioma

115
Q

What are the clinical features of ossifying fibroma?

A
  • A bone tumor containing fibrous tissues and abnormal bone
  • May have similar features as a fibrous dysplasia (to be discussed later)
    except a soft tissue capsule.
  • Any age, but mostly young adults
  • More females than males
  • Grows rapidly, displaces teeth
116
Q

What is the location of ossifying fibroma?

A

In facial bones, mostly mandible

117
Q

What is the border of ossifying fibroma?

A
  • Well‐defined, has a lucent (fibrous) capsule
  • Sclerotic border may be present
118
Q

What is the internal content of ossifying fibroma?

A
  • Mixed density
  • If radiolucent, there are hints of calcification
119
Q

What is the effect of ossifying fibroma?

A
  • Expansion of cortices—concentric growth
  • Displacement of teeth or canal
120
Q
A

ossifying fibroma

121
Q
A

ossifying fibroma

122
Q
A

ossifying fibroma