Exam 6-NEOPLAMS of Bone-Benign Flashcards
Benign Vs. Malignant: Benign- Asymptomatic, grows _____ and by expansion: _____ teeth and ______ the cortex, symmetrical, does not metastasize
slowly…displaces…expands
Benign Vs. Malignant: Malignant- Usually symptomatic, grows more ______, ______ and destroys adjacent structures, often asymmetrical, ragged or poorly defined borders and destroys cortex, lays down bone ______ the cortex, capable of metastasis
rapidly…INVADES…OUTSIDE
What are the 4 Bone Neoplasms/Growths that are BENIGN?
1.Exostoses 2.Osteoma 3.Osteiod Osteoma 4.OsteoBlastoma
What are the 3 bone neoplasms that are Cartilagenous in nature??
1.Chondroma 2.Chondromyxoid fibroma 3.Benign ChondroBlastoma
What is the bone neoplasm that is of Fibrous origin?
Desmoplastic Fibroma
What is a localized proliferation of bone that arises from the cortical plate?
an Exostoses
An exostoses is a localized proliferation of bone that arises from the _______ plate with minimal to NO _______ bone involvement
cortical…medullary
What are the fancy Latin names for exostoses on the mandible? maxilla?
Torus Palatinus, Torus Mandibularis
What is the most common site for an exostosis?
Buccal area of maxillary or mandibular alveolar ridge is the most common site
Are exostoses often unilateral or bilateral?
Bilateral
What age group is most affected by exostoses?
adults
Although exostoses are just a bony hard, elevated, nodular lesion and are asymptomatic, the thin overlying mucosa may ______ easily
ULCERATE
Where are Torus Palatinus ALWAYS located???
midline of the hard palate
The etiology of Torus Palatinus is probably _______
multifactorial
Where is a Torus Mandibularis located?
Lingual Premolar area of the mandible
What % of Torus Mandibularis are bilateral?
90%!
What is a localized proliferation of bone that MAY be indistinguishable from tori, but it does have the distinguishing factor of involving the medullary bone OR cortical bone (torus is just cortical)???
an Osteoma
The TYPE of bone in an osteoma is variable, from dense, compact ______-like bone without significant marrow to
______ bone with trabecular pattern and marrow
cortical…Cancellous
Osteomas are almost EXCLUSIVE to what region of the body??
craniofacial skeleton
Osteomas are MOST OFTEN _______ lesions and are asymptomatic
SOLITARY
Getting a bit more specific, we know ostemas are almost exclusive to the craniofacial skeleton, but where in this region is their predilection?
sinuses
Osteomas GENERALLY have a limited growth potential, BUT they CAN reach a large size and produce ______
deformity
What is the NUMBER 1 thing for dentists to think about when they see an osteoma?
GARDNER’s SYNDROME
Which benign bone lesion is GARDNER’s SYNDROME associated with??
Osteomas
An aside, probably not on the test but mentioned in class-what % of Pts with Gardner’s Syndrome will present with osteomas?
80% (New England Journal of Medicine)
What type of genetic inheritance is Gardner’s Syndrome?
Autosomal Dominant
Ok, ok I get it. Gardner’s syndrome has multiple osteomas…but WHERE are they most commonly found??
Angle of the Mandible
Along with the classic sign of osteomas in Gardner’s syndrome, what other dental anomaly is it associated with?
supernumerary teeth
What are the three types of cysts/tumors/and polyps found in patients with Gardner’s Syndrome?
1.Muliple Epidermoid Cysts 2.Desmoid Tumors 3.Multiple Adenomatous polyps of the colon and rectum
Which lesion in patient’s with Gardner’s Syndrome transforms to MALIGNANT 100% OF THE TIME?
the Adenomatous Polyps of the colon/rectum
What is the “TRUE” neoplasm of bone that is RARE? How RARE is it?
An Osteiod Osteoma…less than 1% of all bone tumors
the RARE Osteoid Osteoma has a wide age range but 85% of the time will affect people less than ___ years of age..Which sex does it affect more?
30…Males 2:1
What are the two CLASSIC clinical symptoms/treatments of an osteiod osteoma?
1.Nocturnal Pain 2.Relieved by Aspirin
Oooo Osteoid Osteomas are juicy with distinguishable traits….what is the CLASSIC radiographic appearance?
“target”
Which benign bone neoplasm has the radiographic appearance of a “target”?
osteoid osteoma
Which benign bone neoplasm presents with noctornal pain and is relieved by aspirin?
osteoid osteoma
Radiographic representation of osteoid osteomas: Small lesion, less than ____ in diameter Central _____
Peripheral radiolucent “_____” and a _______ rim
1cm…opacity…“halo”….corticated
Which true neoplasm of bone is really similar to an osteoid osteoma in that they are RARE and are less than 1% of all bone tumors?
OsteoBlastoma
Osteoblastomas have a propensity for occurrence in which region of the body? Which area MORE SPECIFICALLY?
craniofacial skeleton…the MANDIBLE
Much like an osteoid osteoma, an osteoblastoma is found in a wide age range, but most patients are usually under age ___ and the gender of ______ is 2:1
30..males
One distinguishing factor between an ostroid osteoma and and an osteoblastoma is the size of the lesion. Osteiod osteomas are __cm whereas osteoblastomas are ____
OO: 1cm…osteoblastomas over 2cm
What is a COMMON symptom of an osteoblastoma? How is this distinct from an osteoid osteoma?
pain is a common symptom…1.not nocturnal pain 2.not releived by aspirin
Osteoblastomas may produce SIGNIFICANT ________ and deformity
expansion
What is the ONLY benign neoplasm of cartilage origin we will discuss?
Chondromas
What age range usually presents with chondromas and where are they more commonly found?
20-40 year olds and more common in extremities
Chondromas are exceedingly rare in the _____ region and most diagnosed are ________ chondrosarcomas
head and neck…low grade
Which two benign cartilage neoplasms are so rare in the jaw that we are not even going to talk about them?? :)
Chondro-Myxoid Fibroma and ChondroBlastoma
What is the name for a benign locally aggressive fibrous boney neoplasm?
Desmo-Plastic Fibroma
A _________ is the bone equivalent of soft tissue fibromatosis
desmo-plastic fibroma
What age groups present with desmoplastic fibromas more often?
children and young adults
Desmoplastic Fibromas occur 85% of the time in which arch? What two specific locations in this arch?
Mandible…posterior mandible and ascending ramus
The only definite radiographic feature of a Desmoplastic Fibroma is that it is _________, everything else goes both ways: unilocular to multilocular, borders well defined
or poorly defined
radiolucent
Treatment of Desmoplastic Fibromas-curettage shows a ___% recurrence and resection shows a ___% recurrence.
curettage-70%…resection 20%
