Exam 5-Odontogenic Tumors Flashcards
What are the three classes of odontogenic tumors based on their tissue of origin?
1.Ectodermal (epithelial) 2.Mesodermal (connective tissue) 3. Mixed
What are the 4 types of ectodermal (epithelial) odontogenic tumors?
1.Ameloblastoma 2. Calcifying Epithelial Odontogenic Tumor 3.Adenomatoid Odontogenic Tumor (AOT) 4.Squamous Odontogenic Tumor (SOT)
What is the most likely age range for Ameloblastoma?
Middle age (mid 30’s-40’s)
Where are most Ameloblastomas found?
75% in the mandible, and more often in the posterior mandible
What is usually the first clinical sign of an Amelioblastoma?
Swelling (cortical expansion)
Radiographically: Amelioblastoma May be pericoronal, always radio______, fairly well _______. Classically multi_____, move teeth, and can cause root _______
lucent… circumscribed…..multilocular….resporption
The histo-path of an Ameloblastoma is described as epithelial _______ and cords
islands
If you had only two phrases to describe the histology of an Ameloblastoma, what would they be??
peripheral cells that show 1.PALISADING (columnar) and 2.REVERSE NUCLEAR POLARITY
An ameloblastoma has an interesting spread pattern, it can invade ______ bone, but tends to EXPAND the ______ bone.
invades medullary bone….expands cortical bone
What is the treatment for an ameloblastoma? What is the recurrence rate?
aggressive curettage…50%
Is a peripheral (extraosseus) ameloblastoma MORE or LESS aggressive??
LESS aggressive
What is the term for an ameloblastoma that is a solitary cyst in which the it is CONFINED to the epithelial lining or cyst lumen…IS it more or less aggressive? What is the recurrence rate with enucleation?
UNICYSTIC…less aggressive, recurrence 10-25% with enucleation
What are the two variants of ameloblastoma that metastasize?
1.Malignant ameloblastoma 2.Ameloblastic carcinoma
Can you definitively diagnose variants of ameloblastoma via an incisional biopsy?
Nope
What is another name for a Calcifying Epithelial Odontogenic Tumor?
Pindborg Tumor (CEOT)
What is the “official” name of a Pindborg tumor?
Calcifying Epithelial Odontogenic Tumor
What is the most common location for an CEOT (Pindborg Tumor)?
midbody of the mandible
Since the radiographic appearance of CEOT is radiolucent and mixed radiolucent/opaque, what is the nickname for the lesion?
“driven snow”
What is a CEOT (Pindborg Tumor) often associated with?
Unerupted teeth (pericoronal)
What type of ectodermal odontogenic tumor is described as islands and sheets of pleomorphic epithelial cells?
Calcifying Epithelial Odontogenic tumors (Pondborg tumor)
Interesting…in a CEOT (Pindborg Tumor) tumor cells are ______ and produce protein matrix similar to ______ matrix (stains with amyloid stains) and may calcify.
functional…enamel
What is the most common age range, sex, and placement of an Adenomatid Odontogenic Tumor (AOT)?
Teenage girls, maxillary anterior region (associated with uninterupted teeth)
How does an AOT appear on a radiograph? (2 descriptions please)
Radiolucent (pericoronal), flecks of opacity
Which epithelial odontogenic tumor am I describing?? Encapsulated, swirls of epithelial cells containing rosettes or DUCT-like spaces lined by cuboidal or columnar cells.
Adeno-Matid Odontogenic Tumor
What is the treatment for an AOT?
Adeno-matid odontogenic tumors get ENUCLEATED (they come out real easy)
Which odontogenic tumor is not distinguishable clinically, and appears as islands of well-differentiated squamous epithelium and the peripheral layer of cells flattened…
Squamous Odontogenic Tumor (SOT)
What does a Squamous Odontogenic Tumor appear as radiographically?
RadioLUCENT around tooth roots
What is a positive about SOTs?
Low recurrence rate with curettage
What are the 4 types of MESODERMAL odontogenic tumors?
1.Central Odontogenic Fibroma 2.Peripheral Odontogenic Fibroma 3.Odontogenic Myxoma 4.Cementum Lesions
What are the three types of cementum lesions?
1.Central cemento-ossifying fibroma (ossifying fibroma, cementifying fibroma) 2.Benign cementoblastoma (TRUE cementoma) 3.Gigantiform cementoma
Which mesodermal odontogenic tumor currently is described as simple and WHO types? (will change soon)…
Central Odontogenic Fibroma
How might a central odontogenic fibroma appear on a radiograph?
lucent to mixed lucent/opaque
Which mesodermal odontogenic tumor is described as a reactive gingival lesion of PDL origin? What age group is it most prevalent in? What ragion of the mouth?
Peripheral Odontogenic fibroma…young people, anterior gingiva
What type of odontogenic tumor is this describing?: Cellular fibrous connective tissue with calcifications, bone, cementum, dystrophic.
Peripheral Odontogenic fibroma
What are two normal developmental tooth structures that are often confused with an odontogenic myxoma?
dental papilla and hyperplastic dental follicle
Although an odontogenic myxoma can occur in all ages, which age group is it seen the most?
young peeps
An odontogenic myxoma often presents radiographically as Lucency often containing residual opaque _______
trabeculae
Which mesodermal odontogenic tumor is this describing?Hypocellular tumor, scattered plump fibroblastic cells. Delicate collagen fibrils and abundant ground substance
(glycosaminoglycans).
Odontogenic Myxoma
What is the treatment of an odontogenic myxoma and why?
BLOCK rescetion…curettage has a HIGH recurrence rate
What is the neoplasm of PDL origin that is more common among black females in the mandible?
central cemento-ossifying fibroma (ossifying fibroma)
What are the symptoms presented with a central cemento-ossifying fibroma?
ASYMPTOMATIC
Even though this odontogenic tumor is associated with roots, the teeth should be VITAL!
Central cemento-ossifying fibroma
LOL, how does a central cemento-ossifying fibroma present radiographically? (radiopaque?lucent?)
Completely lucent to mixed lucent/opaque to mostly opaque…LOL
Which type of odontogenic tumor is this describing? Very cellular fibroblastic stroma (fibroma) containing trabeculae of bone with cellular inclusions (ossifying) or
“globules” of acellular cementum (cementifying) or both (cemento-ossifying). Usuallyencapsulated….
Central cemento-ossifying fibroma
How is a central cemento-ossifying fibroma treated?
enucleated
What is the nickname for a benign cementoblastoma?
a TRUE cementoma
What is the most common age group and place for a true cementoma (bengin cementoblastoma)?
2-4th decades of life, in the mandibular first molar area
What is the distinguishing factor between a benign cementoblastoma and condensing osteitis?
cementoblastoma-tooth is VITAL, condensing osteitis-non-vital
What are three distinguishing radiographic factors of a benign cementoblastoma?
1.Radiopaque 2.Ankylosed 3.Encapsulated
What type of odontogenic tumor is this describing? Sclerotic trabeculae of cementum with variable amounts of “active” fibroblastic stroma with giant cells. Peripheral trabeculae characteristically at right angles to surface. Central trabeculae fused to tooth root….
Benign cementoblastoma (true cementoma)
What is the recurrence rate of a benign cementoblastoma?
0-37%
What is the extremely rare cementum lesion that is purely genetic-autosomal dominant?
Gigantiform cementoma
What is unique about the location of Gigantiform cementoma?
MULTI-quadrant globular opacities
Which odontogenic tumor is Globular, sclerotic masses of cementum, Histology not diagnostic, and is usually not treated?
Gigantiform cementoma
What are the three types of mixed odontogenic tumors?
1.Ameloblastic fibroma 2.Ameloblastic fibro-odontoma 3.Odontoma
When and where does an ameloblastic fibroma occur? What are the symptoms?
decades 1-3 (if you have one past 30 years old, it was made when you were younger)….found in the mandibular posterior…ASYMPTOMATIC
How does an Ameloblastic fibroma appear on a radiograph?
ALWAYS radioLUCENT
Which odontogenic tumor is this describing? Long strands or cords of epithelial cells resembling dental lamina in a highly cellular connective tissue of fibroblasts and delicate collagen fibrils….
Ameloblastic Fibroma (mixed odontogenic tumor)
An ameloblastic fibroma is characterized by long strands or cords of EPITHELIAL cells resembling _________ in a highly cellular CONNECTIVE tissue of fibroblasts and delicate collagen fibrils.
DENTAL LAMINA
What is the only variant of an ameloblastic fibroma?
Ameloblastic FIBROsarcoma (malignant transformation of mesenchymal (fibrous connective tissue) component)
Which type of mixed odontogenic tumor shows SOME areas like an ameloblastic fibroma and OTHER areas like an odontogenic tumor (enamel,dentin, cementum formation)??
An ameloblastic FIBRO-ODONTOMA
Which two odontogenic tumors present with palisading peripheral cells with reverse nuclear polarity?
- Ameloblastoma 2. Ameloblastic Fibro-odontoma
When does an Ameloblastic fibro-odontoma occur? What are the symptoms?
1-3 decades…ASYMPTOMATIC
What are the radiographic findings for an Ameloblastic fibro-odontoma? (hint-its an odontogenic tumor of MIXED origin), where will you OFTEN find these?
mixed radiolucent/opaque…often found overlying an unerupted tooth
Not sure I understand this, but what the hell…Which odontogenic tumor is this??: In
functional areas, morphology recapitulates normal odontogenesis in that epithelial component “opens up” like enamel organ
Ameloblastic Fibro-Odontoma
WHAT IS THE MOST COMMON ODONTOGENIC TUMOR??? What type of odontogenic tumor is it?
an ODONTOMA…its a mixed (epithelial and connective tissue) odontogenic tumor
The MOST COMMON odontogenic tumor: an odontoma, is both epithelial and _________ cells functional and produce products of odontogenesis.
mesenchymal (they are just little teeth :)
The MOST COMMON odontogenic tumor: an odontoma,Viewed as a developmental ________, not a neoplasm
hamartoma (a tumor resembling the normal surrounding tissue)
The VERY UNIQUE radiographic presentation of an odontoma: Radio_____ with thin _____ border (follicle) often overlying unerupted teeth.
opaque…lucent border
What are the two types of radiographic presentations of an odontoma?
Compound and Complex
In a compound odontoma it appears ______ like and it is mainly found in the _______ jaws
TOOTH…anterior
In a complex odontoma it appears more like a ______ deposition and it is mainly found in the _____ jaws
RANDOM…posterior
What other type of odontogenic tumor can an EARLY odontoma resemble?
Ameloblastic fibro-odontoma
A LATE odontoma will show what signs?
mature enamel, dentin, cementum, and PULP!
The typical treatment for odontomas is surgical resection because they can develop complications…what are two examples of complications?
a dentigerous cyst or ameloblastoma
Which 4 odontogenic tumors are associated with UNERUPTED TEETH?
1.CEOT 2.AOT 3.Ameloblastic Fibro-Odontoma 4. Odontoma
