Exam 3 ST Masses (Developmental) Flashcards
Name the pathology:
Ectopic sebaceous glands, Multiple yellow-white
papules
Fordyce Granules
Etiology of Fordyce granules.
Ectopic sebaceous glands
What is the prevalence of Fordyce Granules?
Present in over 80% of the
pop
How would you diagnose and tx Fordyce granules?
Dx - clinical presentation
Tx - NONE
Name the pathology:
Superficial dilated tortuous veins, Weakening of blood vessel walls and loss of tone in supporting CT
Varix/Varicosities
Varix/Varicosities occur in ____ of people over the age of _____.
2/3rds; 60
T/F Varix are common in children
FALSE
Describe clinical presentation of varix
Blue-purple nodules
May be solitary or multiple
Can become thrombosed (firm)
Common on ventral and lateral surfaces of the tongue
Common on lips and buccal mucosa
What site are you likely to find varix in the oral cavity?
ventral and lateral surfaces of the tongue
lips and buccal mucosa
How would you diagnose varix?
Usually a clinical diagnosis can be made BUT Biopsy for solitary varicosities of the lip and buccal mucosa may be indicated.
How would you tx varix?
NO tx
What are the developmental ST masses that we said did not need tx?
Fordyce granules
Varix/Varicosities
Lymphoepithelial cyst (unless want to remove)
Lingual thyroid - sometimes hormone therapy
Name the pathology:
Derived from rests of dental lamina
Soft tissue counterpart to lateral periodontal cyst
Gingival cyst of the adult
Where are you most likely to find gingival cyst of the adult in the oral cavity? (site)
Predilection for mandibular canine and premolar area
Always on facial gingiva/alveolar mucosa
Describe the clinical presentation of Gingival cyst of the adult.
Painless, domelike swelling
Bluish-gray color
May cause “cupping out” of alveolar bone
How would you diagnose and tx Gingival cyst of the adult?
Biopsy and excisional biopsy
What does Gingival cyst of the adult arise from?
Rests of dental lamina
Name the pathology:
Keratin filled cyst arising from hair follicle
Epidermoid cyst
Epidermoid cyst are unusual to have before ______.
Puberty
Site to find Epidermoid cyst
Common in acne prone areas of head, neck, and back
Not found intraorally
What developmental ST mass is NOT found in the oral cavity?
Epidermoid cyst
Describe clinical presentation of Epidermoid cyst
Nodular, fluctuant subcutaneous lesion
White or yellow (red if inflamed)
How to tx epidermoid cyst?
Excisional biopsy
How to diagnose epidermoid cyst?
Biopsy
Name the pathology:
Occlusion and dilation of a crypt of
lymphoid tissue
Lymphoepithelial cyst
Demographic to find Lymphoepithelial cyst
Young adults
Site to find Lymphoepithelial cyst (think about order)
Floor of mouth
Ventral tongue
Posterior lat border of tongue
Soft palate
Palatine tonsil
Describe the clinical presentation of Lymphoepithelial cyst
Small submucosal mass
Firm or soft to palpation
Typically white or yellow
How to diagnose Lymphoepithelial cyst
Clinical diagnosis
Biopsy
How to treat Lymphoepithelial cyst
Excisional biopsy or NO tx
Name the pathology:
Ectopic thyroid tissue
Failure of thyroid bud to descend normally into neck from foramen cecum
Lingual Thyroid
Lingual Thyroid is more common in males or females?
Females
Name the pathology:
Nodular mass on the posterior dorsal tongue
May be accompanied by dysphagia, dysphonia, and dyspnea
Lingual thyroid
How to diagnose lingual thyroid?
Thyroid scan
Avoid biopsy (risk of hemorrhage and may be pt only functioning thyroid tissue)
How to tx lingual thyroid?
Follow-up;
hormone therapy if necessary
T/F 72% of pt with lingual thyroid are accompanied with hyperthyroidism.
FALSE
HYPOthyroidism
MEN2B is a _____ gene mutation.
RET
Neurofibromatosis type I is a _______ gene mutation.
NF1
T/F Both MEN2B and NF1 have autosomal dominant inheritance pattern.
True
Name the pathology:
“RET gene mutation
Autosomal dominant inheritance pattern “
Multiple Endocrin Neoplasia Type 2B (MEN2B)
Name the pathology:
“NF1 gene mutation
Autosomal dominant inheritance pattern”
Neurofibromatosis type I (NF1)
What are the 3 clinical presentations of MEN2B?
- Mucosal Neuromas (often first sign)
- Medullary thyroid carcinoma
- Pheochromocytoma
T/F Mucosal neuromas are soft, painful papules or nodules that tend to involve oral cavity.
False painless
T/F Mucosal neuromas have NO potential of malignancy
TRUE
Why do you often do a preventative thyroidectomy in a pt with MEN2B?
Because of the increased risk of medullary thyroid carcinoma
What tumors do you have to worry about forming with MEN2B?
Medullary thyroid carcinoma
Pheochromocytoma (adrenal gland tumor) - impending sense of doom extremely high BP
How to diagnose MEN2B?
Biopsy of oral lesions
Genetic testing
How to tx MEN2B?
Preventative thyroidectomy
Observation for development of pheochromocytoma
What clinical presentation are present with NF1? (4 things)
- Multiple neurofibromas of skin and mucosa with Potential to become malignant peripheral nerve sheath tumor
- Cafe au lait macules (light brown skin pigmentation)
- Axillary and inguinal freckling
- Lisch Nodules (pigmentation defects of iris)
Multiple neurofibromas of SKIN and MUCOSA have the potential to become malignant _________ ________ ____________ _________.
peripheral nerve sheath tumor
How to diagnose NF1?
Biopsy
Genetic testing
How to tx NF1?
Cosmetic excision of neurofibroma (if possible)
Monitoring for signs of malignant peripheral nerve sheath tumor
