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Radio II: Exam 2 > E2: Malignant tumors of the jaws > Flashcards

E2: Malignant tumors of the jaws Flashcards

1
Q

Uncontrolled growth and locally invasive, metastasizes to lymph nodes or to distant
parts is called _____.

A

malignancy

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2
Q

Malignancy of epithelial origin

A

carcinoma

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3
Q

Malignancy of mesenchymal origin

A

sarcoma

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4
Q

What are the possible origins of malignancy?

A

epithelial, mesenchymal and hematopoetic origin

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5
Q

Who is at risk for developing cancer?

A

everyone
increases with age
80% with cancer are 55+ years of age

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6
Q

How common is oral and pharynx cancer?

A

2.8%

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7
Q

Median age for oral and pharynx cancer

A

64

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8
Q

How long does it take to diagnose and treat a patient? What are the different types of delay?

A
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9
Q

What is the location for oral cancer?

A
  • Anywhere
  • Carcinoma in the tongue, FOM, tonsillar area, lips
  • Sarcoma in mandible, or posterior jaws
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10
Q

What is the border for oral cancer?

A

Poorly defined, lacks cortication, no capsule, extends into different depth

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11
Q

What is the internal content for oral cancer?

A

Usually radiolucent

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12
Q

What is the effect for oral cancer?

A

Rapid destruction, destroys bone rather than roots, minimal displacement of
teeth, sarcomas may resorb roots, destroys cortical bone

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13
Q

What is the clinical feature of squamous cell carcinoma?

A
  • Originates from surface epithelium
  • Spreads by invasion
  • Pain, paresthesia, sudden loosening of teeth, foul smell, weight loss
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14
Q

What is the location of squamous cell carcinoma?

A
  • Lateral border of the tongue –> radiographic findings on posterior border of
    the mandible
  • Lip or FOM –> radiographic findings on anterior mandible
  • Sinus mucosa –> radiographic findings on hard palate
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15
Q

What is the border of squamous cell carcinoma?

A
  • Irregular, rarely smooth, sclerosis of surrounding bone only if the tumor is
    infected
  • Pathologic fracture
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16
Q

What is the internal content of squamous cell carcinoma?

A

totally radiolucent

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17
Q

What is the effect of squamous cell carcinoma?

A
  • Widened PDL with loss of lamina dura
  • ‘Floating’ teeth
  • Destruction of the cortex, and pathological fracture
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18
Q
A

squamous cell carcinoma

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19
Q

What are the characteristics of metastatic tumors?

A
  • A new malignant tumor originating from a distant lesion
  • Usually by blood vessels
  • Primary sites: breast, kidney, lung, colon, prostate, thyroid
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20
Q

What is the location of metastatic tumors?

A
  • Posterior areas of the jaws
  • Mandible>maxilla, can be bilateral, PDL spaces
  • Maxillary sinus
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21
Q

What is the border of metastatic tumors?

A
  • Fairly well-defined, but no cortication. Invasive margins
  • Sclerotic if primary lesion is breast or prostate
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22
Q

What is the internal content of metastatic tumors?

A
  • Mostly radiolucent
  • May be multifocal
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23
Q

What is the effect of metastatic tumors?

A
  • Periosteal reaction
  • Increase width of PDL, with loss of lamina dura
  • ‘Floating’ teeth
24
Q
A

metastatic neoplasm

25
Q

What are the characteristics for osteosarcoma?

A
  • Malignant tumor that produces osteoid
  • Rare in the jaws, about 7%
  • Osteoblastic, chondroblastic and fibroblastic
  • Jaw lesions appear later: average delay 10 years
26
Q

What is the location of osteosarcoma?

A

Mandible>maxilla, posterior area, alveolar ridge

27
Q

What is the border of osteosarcoma?

A
  • Poorly defined,
  • Linear bony trabeculation when affects the cortex
28
Q

What is the internal content of osteosarcoma?

A
  • Entirely radiolucent: osteolytic osteosarcoma
  • Mixed
  • Mostly radiopaque: osteogenic
29
Q

What is the effect of osteosarcoma?

A
  • Widening of PDL spaces
  • Destroys sinus and nasal walls
  • Destroys canal
30
Q

What are the characteristics of chondrosarcoma?

A
  • Malignant tumor of cartilaginous origin
  • Centrally in bone, on the periphery or on soft tissues
31
Q

What is the location of chondrosarcoma?

A
  • Rare in the jaws, about 10%
  • Mandible = maxilla
  • Maxilla : Anterior region
  • Mandible: coronoid or condylar area
32
Q

What is the border of chondrosarcoma?

A
  • Well defined, round, ovoid
  • May have trabecular appearance as in osteosarcoma
33
Q

What is the internal content of chondrosarcoma?

A
  • Some calcification
  • Not completely radiolucent
34
Q

What is the effect of chondrosarcoma?

A
  • Expands cortex
  • Pushes sinus wall
  • Remodeling of the condyle
35
Q

What are the clinical features of fibrosarcoma?

A
  • Composed of malignant fibroblasts
  • May arise after radiation therapy
36
Q

What is the location of fibrosarcoma?

A
  • Mostly mandible
  • Premolar /molar region
37
Q

What is the border of fibrosarcoma?

A
  • Ill-defined, ragged border
  • Noncorticated, no capsule
38
Q

What is the internal content of fibrosarcoma?

A
  • Tend to follow marrow space, grows along a bony margin
  • Mostly lucent
  • Reactive bone may be present
39
Q

What is the effect of fibrosarcoma?

A
  • Destruction of bone, reactive bone formation
  • Loss of lamina dura
  • Root resorption rare, but displacement common
40
Q

What is the characteristics of multiple myeloma?

A
  • Arises from cells of bone marrow that have resemblance to plasma cells.
  • Mean age: 55-60 years. Rarely seen <35.
  • More common in males.
  • Pain, swelling, expansion, numbness, mobility.
  • Presence of Bence-Jones protein >60% of patients.
41
Q

What is the border of multiple myeloma?

A

Radiographically, several, discrete, well-defined, “punched out” radiolucencies
seen in jaws and several other bones of the body.

42
Q

What is the internal content of multiple myeloma?

A
  • Radiolucent areas may expand and coalesce into larger areas and may cause
    fractures.
  • Usually none
  • Some bony islands may be visible
43
Q

What is the effect of multiple myeloma?

A

Thinning and disruption of bone

44
Q

What are the clinical features of Non-Hodgkin’s Lymphoma?

A
  • Mostly in lymph nodes
  • Can occur in bone, skin, GI tract
  • Many subtypes: Low grade to high grade
  • New cases in 2007 : 63,000, death 18,000
  • Rare in first decade
45
Q

What is the location of Non-Hodgkin’s Lymphoma?

A
  • Lymph nodes
  • Sinus, posterior mandible, maxilla
46
Q

What is the border of Non-Hodgkin’s Lymphoma?

A
  • Takes up the shape of the bone
  • Untreated lesions destroy bone
  • Rounded and multiloculated
47
Q

What is the internal content of Non-Hodgkin’s Lymphoma?

A
  • Usually radiolucent
  • Rarely bone formation
48
Q

What are the clinical features of Burkitt’s Lymphoma?

A
  • African and American
  • African type: Jaw involvement, young children
  • American type: usually no jaw involvement, young adults
  • Rapid growth, doubling time of 24 hours
49
Q

What is the location of Burkitt’s Lymphoma?

A
  • African type: one or both jaws, posterior part
  • American type: abdomen
50
Q

What is the border of Burkitt’s Lymphoma?

A
  • Multiple, ill-defined , non-corticated lesions
  • Merges into one large lesion
51
Q

What is the internal content of Burkitt’s Lymphoma?

A

Mostly radiolucent

52
Q

What is the effect of Burkitt’s Lymphoma?

A
  • Displaced teeth and buds
  • Destroys lamina dura
53
Q

What are the characteristics of leukemia?

A
  • Tumor of hematopoietic stem cells
  • Usually no signs or symptoms
  • Weakness and bone pain
  • Loose teeth
54
Q

What is the location of leukemia?

A

throughout the jaw

55
Q

What is the border of leukemia?

A

Ill-defined radiolucency

56
Q

What is the internal content of leukemia?

A

Granular bone, patchy radiolucency

57
Q

What is the effect of leukemia?

A
  • Premature loss of teeth
  • Displacement of the developing teeth

Radio II: Exam 2 (8 decks)

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