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Oral Pathology > Exam 2: 2/27: Benign non-odontogenic tumors > Flashcards

Exam 2: 2/27: Benign non-odontogenic tumors Flashcards

1
Q

Coronoid hyperplasia:

A

rare developmental, osteoma or osteochondroma, esp male, uni or bi lateral, limits man move, painless, treat w coronoidectomy ro coronoidectomy

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2
Q

Condylar hyperplasia

A

uncommon, female:male:3:1, facial asymmetry, prognathism, cross + open bite, treat: condylectomy or osteotomy

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3
Q

TF? Both Condylar hyperplasia and coronoid hyperplasia:present w facial asymmetry.

A

F, only condylar hyperplasia

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4
Q

Bifid condyle:

A

rare, developmental, double headed condyle, usually unilateral, asymptomatic, may have pop or click of TMJ, no tx

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5
Q

Condylar hypoplasia:

A

underdeveloped condyle, congenital or acquired, syndromes (mandibulofacial dysostosis)

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6
Q

Condylar aplasia:

A

no development of condyle or ramus

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7
Q

Exostoses:

A

localized nodular bony protuberance, non-neoplastic*, developmental, very common, genetic or env factors, rarely symptomatic, single or multiple

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8
Q

How to name exostoses:

A

Buccal, palatal, torus palatinus, mandibularis, other sites: simple exostoses

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9
Q

More likely to be bilateral, buccal or palatal exostoses:

A

buccal

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10
Q

Buccal exostoses:

A

bilateral, max and/or mand, esp pos, male=female, 1/1000 adults

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11
Q

Palatal exostoses:

A

lingual of max tuberosities, bi or unilateral, 30-69%, esp males

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12
Q

Ddx, exostoses:

A

osteoma

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13
Q

Torus palatinus:

A

sessile, nodular bony mass along midline, 2:1 female, genetic? simple dominant? esp Asians and Inuits, 20-35%

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14
Q

Torus mandibularis:

A

sessile, single or multiple, nodular bony mass, usually bilateral, on lingual cortical bone, cuspid/ premolar area, female = male, esp Asians and Inuits, 7-10%

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15
Q

Histo of tori:

A

dense cortical bone, sclerosis, loss of marrow spaces

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16
Q

When to treat tori:

A

interfere w dentures, freq trauma, interfere w taking X-rays

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17
Q

Bony mass that may develop from alveolar bone rest bone beneath the pontic of a pos bridge:

A

reactive subpontine exostosis

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18
Q

2 variants of exostoses:

A

reactive subpontine exostosis, following skin graft vestibuloplasty gingival grafts

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19
Q

Osteoma:

A

benign neoplasm of mature compact or cancellous bone, 20’s-50s, 2:1 male, mainly craniofacial skeleton, inc jaw,

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20
Q

Osteoma on surface of bone:

A

periosteal osteoma

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21
Q

Osteoma that developed centrally within bone

A

endosteal osteoma

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22
Q

Osteoma that developed within muscle or dermis:

A

osteoma cutis

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23
Q

Osteoma cx ft:

A

asymptomatic unless in some locations, slow growing bony mass, body of man or condyle, paranasal sinus osteomas are more common than gnathic, can lead to asymmetry, solitary except w Gardner’s s, for sure dx must have hx of sustained growth

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24
Q

Most common location of osteoma:

A

premolar on L surface

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25
Q

RG appearance of osteoma:

A

well-c, sclerotic, RGO mass

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26
Q

Ddx, osteoma:

A

exostosis, complex odontoma, focal sclerosing osteomyelitis, osteoid osteoma, osteoblastoma, ossifying fibroma

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27
Q

2 variant of osteoma:

A

compact w sparse marrow tissue, cancellous w abundant fibrofatty marrow space

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28
Q

Recurrence rate of osteoma following removal:

A

don’t recur

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29
Q

How to dx osteoma:

A

surgical excision

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30
Q

Tx for small asymptomatic osteoma:

A

periodic observation

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31
Q

Multiple osteomas is aka:

A

Gardner’s syndrome

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32
Q

Inheritance pattern and mutation of Gardner’s Syndrome:

A

autosomal dominant, APC tumor suppressor gene, chromo 5 (5q21)

33
Q

Gardner’s syndrome is characterized by:

A

intestinal polyposis (premalignant, adenocarcinoma), benign soft tissue tumors of skin (fibroma, lipomas, neurofibromas, leiomyomas), odontomas, supernumerary teeth and impacted teeth, epidermoid cyst of skin, congenital hypertrophy of the retinal pigment epi

34
Q

benign soft tissue tumors of skin:

A

fibroma, lipomas, neurofibromas, leiomyomas

35
Q

Chondroma:

A

benign tumor of mature hyaline cartilage, anterior maxilla, symphysis, coronoid process and condyle, excise, may be a chondrosarcoma if in jaw

36
Q

Central giant cell granuloma;

A

benign, almost only in max and man, usually single RGL in man or max

37
Q

Cx ft, CGCG:

A

64-75% before 30yo, females 2:1, usually man ant to molars, freq crosses midline, typically painless expansion or swelling, non-aggressive or aggressive

38
Q

CGCG RG presentation:

A

uni or multilocular RGL, well-d, non-corticated margins, distinct pattern of outer cortical plate expansion, septae at right angles to cortex

39
Q

Histo of CGCG:

A

multinucleated giant cells throughout CT, proliferation of spindle fibroblasts, many small vascular channels, hemosiderin-laden macs

40
Q

Peripheral giant cell granuloma:

A

CGCG soft tissue lesion, microscopically similar lesion on gingival tissues, no RG findings, sometimes “cupping resorption”

41
Q

How to determine tx for CGCG:

A

whether it is aggressive or not

42
Q

Tx for nonaggressive CGCG:

A

surgery, aggressive curettage, good px, low recurrence

43
Q

Tx for aggressive CGCG:

A

tendency to recur after conservative surgical tx - corticosteroids, calcitonin or interferon alfa-2a

44
Q

Cx findings of aggressive CGCG:

A

may cause pain, rapid growth, root resorption, perforation of cortical bone

45
Q

Ddx, CGCG if solitary multilocular RGL:

A

Ameloblastoma, odontogenic myxoma, OKC, aneurysmal bone cyst

46
Q

Ddx, CGCG if solitary unilocular RGL:

A

cystic processes of the jaw

47
Q

Ddx, CGCG if Brown tumor of primary hyperparathyroidism:

A

check?

48
Q

How to differentiate bw CGCG and 1’ hyperparathyroidism:

A

blood test

49
Q

TF? Blood tests will be normal for CGCG.

A

T

50
Q

Blood work for pt w 1’ hyperparathyroidism:

A

inc PTH, Ca and alkaline phosphatase, dec phosphorous

51
Q

Central hemangioma, aka:

A

hemangioma of the bone

52
Q

Central hemangioma:

A

uncommon intraosseous lesion of proliferating BV’s, may be true neoplasm, also a soft tissue type, most developmental or traumatic in origin

53
Q

Cx ft, Central hemangioma:

A

1/2 in pos man, female 2:1, 20’s, either venous or arteriovenous malformation, usually firm, slow-growing, asymmetric expansion of man or max, paresthesia or pain, +/- mobility, spontaneous bleeding, bruits or pulsation of large hemangiomas or arteriovenous malformations may be detected w careful auscultation or palpation of the thinned cortical plates

54
Q

RG ft, CH:

A

varies greatly, 50%+ multilocular RGL w soap bubble appearance, rounded RGL in ant max w coarse patten, bony trabeculae radiate from center

55
Q

Ddx, CH, multilocular:

A

Ameloblastic fibroma, aneurysmal fibroma, OKC, ameloblastoma, odontogenic myxoma, CGCG

56
Q

This can help in dx of CH:

A

angiography to show vascular proliferation

57
Q

Histo, CH:

A

proliferation of BVs: large, cavernous vessels or small, capillary vessels, or mix of both

58
Q

Tx of CH:

A

Needle aspiration 1st!, could be of vascular origin, then biopsy. Tx: surgery, radiation, sclerosing agents, cyrotherapy, presurgical embolization techs

59
Q

Consequence of extraction in area involved by a central vascular lesion:

A

potentially fatal bleeding

60
Q

Presentation of both Osteoblastoma and osteoid osteoma:

A

benign neoplasia, vertebrae- long bones, tooth bearing region of the max and man, 20’s, male 2:1, bony cortices may be expanded, pain, well-c, RGMixed, osteoid and immature bone, prominent vascular network, tx: local excision or curettage, rarely recur - aggressive osteoblastoma

61
Q

How to differentiate bw Osteoblastoma and osteoid osteoma:

A

blastoma: greater that 1.5cm, pain not well-relieved by aspirin, osteoid osteoma: less than 1.5cm, produce prostaglandins, pain is relieved by aspirin, nocturnal pain

62
Q

Ddx, Osteoblastoma and osteoid osteoma:

A

Cementoblastoma, osteoma, ossifying fibroma, fibrous dysplasia

63
Q

Fibro-osseous lesions of jaw:

A

replacement of normal bone by fibrous tissue w a newly formed mineralized product, inc developmental lesions, reactive or dysplastic processes and neoplasias, Cx, RG, and histo correlations, tx varies from none to surgical re-contouring to complete removal

64
Q

Benign fibro-osseous lesions:

A

ossifying fibroma, fibrous dysplasia, cemento-osseous dysplasia

65
Q

Ossifying fibroma is aka:

A

cemento-ossifying fibroma

66
Q

3 types of cemento-osseous dysplasia:

A

focal cemento-osseous dysplasia, periapical cemento-osseous dysplasia, florid cemento Osseous dysplasia

67
Q

Fibous dysplasia:

A

developmental, tumor-like, medullary bone replaced by abnormal fibrous CT intermixed w irregular bony trabeculae, sporadic, results in post-zygotic mutation in GNAS gene (carried in blasts melanocytes and endocrine cells)

68
Q

3 categories of fibrous dysplasia:

A

monocystic, polycystic, polycystic and cafe au lait: Jeffe-Lichtenstsein syndrome

69
Q

What determines which type of fibrous dysplasia will progress?

A

timing of the mutation

70
Q

Which fibrous dysplasia is which, early mutation in a stem cell, mutation in skeletal progenitor cells at later stage of embryonic development, or mutation during postnatal life:

A

monocystic: postnatal, polycystic: later stage of embryonic development, poly w cafe au lait: early mutation in a stem cell

71
Q

What gene is the early mutation in a stem cell of with PFD w cafe au lait?

A

GNAS 1, carried in blasts, melanocytes, and endocrine cells

72
Q

The fibrous dysplasia lead to endocrine disturbances

A

PFD w cafe au lait

73
Q

Cx ft of fibrous dysplasia:

A

mono or polycystic, Jaffe-Lichtenstein syndrome, McCune-Albright syndrome, Mazabraud syndrome (MFD or PFD and intramuscular myxomas)

74
Q

Monocystic fibrous dysplasia:

A

Limited to single bone, 80-85% of all cases of fibrous dysplasia, jaws commonly affected, more common in max, 20’s male = female., asymptomatic, slow growing , usually unilateral, teeth do not become mobile, facial asymmetry

75
Q

Cx ft, Monocystic fibrous dysplasia:

A

When in max often affect adjacent bones like zygoma, sphenoid, and occiput = craniofacial fibrous dysplasia

76
Q

Monocystic fibrous dysplasia, RG ft:

A

diffuse RGO, ground glass or orange peel. In earlier stages, may be largely RGL or mottled

77
Q

Ddx, Monocystic fibrous dysplasia:

A

Ossifying fibroma, chronic osteomyelitis, Paget’s disease

78
Q

Histo, Monocystic fibrous dysplasia:

A

Foci or irregularly shaped trabceulae or woven (immature) bone, the bony trabeculae assume irregular shapes “Chinese script writing”, long standing lesions show lamellar maturation of bone

79
Q

Can Monocystic fibrous dysplasia be dx wo biopsy?

A

yes, should biopsy small lesions though

Oral Pathology (3 decks)

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