Final Revision Flashcards
What is osteomas?
Benign slow-growing tumor composed of mature compact or cancellous bone
types of osteomas:
1 - periosteal
2 - endosteal
3 - extra-skeletal
SOS
In which syndrome we have multiple osteomas?
Gardner syndrome
Where are giant cell granulomas seen more frequently?
anterior portions of the jaws
and
mandibular lesions across the midline
types of giant cell granulomas:
1 - Non-aggressive lesions:
• Small, few or no symptoms, grow slowly, and do not cause cortical perforation or root resorption
2 - Aggressive lesions:
• Pain, rapid growth, cortical perforation, root resorption, tooth displacement, and/or paresthesia
SOS
Which lesions histologically have giant cells?
peripheral giant cell granuloma giant cell tumor cherubism neurofibromatosis brown tumors aneurysmal bone cyst
SOS
most common primary malignancy of bone in children and adolescents:
Osteosarcoma
Osteosarcoma definition:
malignancy of mesenchymal cells that have the ability to produce osteoid or immature bone
Risk factors and pathogenesis of Osteosarcoma:
- Paget disease, fibrous dysplasia
- Inherited conditions
- Issues related to bone growth
Osteosarcoma Types:
central, surface, extra-skeletal(rare)
SOS
what is the most important radiographic characteristic of Osteosarcoma?
sunburst
histological types of osteosarcomas:
1 - Osteoblastic
2 - Chondroblastic
3 - Fibroblastic
- SOS*
2. Which one of the following does NOT contribute to histogenesis of Ameloblastoma?
(a) Developing dental papilla
(b) Developing dental organ
(c) Epithelial lining of odontogenic cyst
(d) Rests of dental lamina
(a) Developing dental papilla
Ameloblastomas - Histologically:
follicular plexiform desmoplastic granular acanthomatous
Most common type of Ameloblastoma:
2nd most common type of Ameloblastoma:
Most common type of Ameloblastoma:
conventional
2nd most common type of Ameloblastoma:
unicystic
- SOS*
6. Which amongst the following radiographic appearances is most likely to represent a conventional ameloblastoma?
(a) Ill-defined, radiolucency
(b) Well-defined unilocular radiopacity attached to root of tooth
(c) Well-defined, mixed radiopaque-radiolucent lesion in anterior maxilla
(d) “Soap bubble/Honeycomb” radiolucent defects with scalloped margins
(d) “Soap bubble/Honeycomb” radiolucent defects with scalloped margins
Unicystic ameloblastoma diagnosis:
asymptomatic swelling, posterior mandible
- Which amongst the following is NOT a histological subtype of unicystic ameloblastoma?
(a) Intramural
(b) Intraluminal
(c) Luminal
(d) Mural
(a) Intramural
Adenomatoid Odontogenic Tumor (AOT) diagnosis:
found in young females
associated with an unerupted tooth
ANTERIOR MAXILLA !!
- Which amongst the following odontogenic tumors is considered to be the least aggressive clinically?
(a) Conventional ameloblastoma
(b) Clear cell odontogenic carcinoma
(c) Ameloblastic fibrosarcoma
(d) Adenomatoid odontogenic tumor
(d) Adenomatoid odontogenic tumor
Calcifying epithelial odontogenic tumor histologically:
Liesegang ring calcifications - amyloid-like material
Ameloblastic Fibroma diagnosis:
benign neoplasm rare slow-growing posterior mandible asymptomatic
- The mesenchymal component of ameloblastic fibroma closely resembles:
(a) Dental organ
(b) Dental follicle
(c) Dental papilla
(d) Dental lamina
(c) Dental papilla
- The ectodermal component of ameloblastic fibroma characteristically proliferates in the form of:
(a) Sheets
(b) Ducts
(c) Large islands
(d) Long narrow anastomosing cords
(d) Long narrow anastomosing cords
- Which is the most common odontogenic tumor?
(a) Ameloblastoma
(b) Unicystic Ameloblastoma
(c) Adenomatoid odontogenic tumor
(d) Odontoma
(d) Odontoma
- Radiographic features of multiple teeth-like structures surrounded by a radiolucent zone are diagnostic of:
(a) Complex odontoma
(b) Odontoameloblastoma
(c) Odontogenic Myxoma
(d) Compound odontoma
(d) Compound odontoma
SOS
Odontogenic Myxoma (OM) diagnosis:
- Most commonly, it occurs in young adults
- The mandible is involved more frequently
- Is usually painless, displacement of teeth
- it reaches considerable size before being detected, and perforation of the cortices of the involved bone may be seen
SOS
MRONJs definition:
=medication related osteonecrosis of the jaw
=area of exposed bone in the maxillofacial region that did not heal within 8w after identification by a health care provider, in a patient who was receiving or had been exposed to a bisphosphonate and didn’t have radiation tx to the craniofacial region
MRONJs stage 2:
exposed necrotic bone - bone that doesn’t bleed
MRONJs treatment:
- eliminate pain
- control infection of the soft and hard tissue
- stop/minimize the progression of disease
- prescribe antibiotics and remove any mobile bony sequestra to facilitate soft tissue healing
- extraction of symptomatic teeth
- histologic analysis for all resected bone specimens
SOS
Which of the lesions is categorized potentially malignant disorder?
(a) ameloblastoma
(b) frictional keratosis
(c) mucoedema
(d) leukoplakia
(d) leukoplakia AND Erythroplakia Oral lichen planus Actinic cheilitis Palatal lesions of reverse cigar smoking Oral submucous fibrosis Discoid lupus erythematosus Dyskeratosis congenita Fanconi anemia
Leukoplakia types:
• Homogeneous leukoplakia, a lesion of uniform flat appearance that may exhibit superficial irregularities, but with consistent texture throughout, generally well-demarcated
• Non-homogeneous leukoplakia, a predominantly white or white and red lesion (erythroleukoplakia)
with an irregular texture that may include ulceration and may be characterised by a speckled, nodular or verrucous topography. These lesions have a higher risk for malignant transformation
Differential diagnosis of Leukoplakia:
candidiasis frictional keratosis hairy leukoplakia fordyce granules leukoderma linea alba nicotine stomatitis chemical burn white sponge nevus
SOS
What is the next step when you find the clinical and differential diagnosis?
biopsy
SOS !!!!!!!!!!!!
Differential diagnosis of Erythroplakia:
Erythematous candidiasis Early SCC Local irritation Mucositis Lichen planus Lupus erythematosus Autoimmune diseases Drug reaction
SOS !!!!!!!
What we will do with a patient having Erythroplakia?
(a) observe
(b) surgical intervention
(c) conservative treatment
(d) biopsy
(b) and (d)
Oral cancer definition
is a malignant neoplasia, affecting any region of the oral cavity, pharyngeal regions and salivary glands
most frequent of all oral neoplasms:
oral squamous cell carcinoma (OSCC)
gold standard assessment for oral cancer:
biopsy and histopathological examination
Oral squamous cell carcinoma - Clinical Features:
- Exophytic
- Endophytic
- Leukoplakic
- Erythroplakic
- Erythroleukoplakic
Oral squamous cell carcinoma locations:
- Tongue
- Floor of the mouth
- Lips
- Palate
- Buccal Mucosa
- Gingiva
Tumor-Nodes-Metastasis (TNM) staging system:
describes the severity and prognosis of disease
Staging:
tells us how to manage a patient the stage of the cancer
What does stage 0 means?
tumor in situ, no lymph nodes, no metastasis
SOS
What does stage III, T3 means?
tumor in t3, no lymph nodes, no metastasis
What does stage IV means?
with any T, with any N, with or without metastasis
What does stage III, T1,T2,T3 means?
with lymph nodes but not any metastasis
Oral squamous cell carcinoma Tx:
- For early stage oral cancers (stages 1 and 2):
- For advanced stage oral cancers (stages 3 and 4):
early stage: surgery or radiation therapy
advanced stage: radio-/ chemotherapy (with surgery)
Amalgam Tattoo diagnosis:
localized lesion, blue-gray macule of the oral mucosa that is evenly pigmented
Name of black-blue line that follows the outlines of the marginal gingiva:
-> caused by:
Burton or Burtonian line
caused by: lead poisoning
If you have a child with blue nevus will you:
(a) assure the mother
(b) benign lesion but need to do biopsy and confirm
(c) nothing you can go home
(b) benign lesion but need to do biopsy and confirm
Types of blue nevus:
common and cellar
Blue nevus - Clinical Features:
- macular or dome-shaped, blue or blue-black lesion smaller than 1 cm
- predilection for the dorsa of the hands and feet, the scalp and face
- mucosal lesions may involve the oral mucosa, conjunctiva, and, rarely, sinonasal mucosa
- oral lesions found on palate
ABCDE Clinical Features of Melanoma:
Asymmetry Border irregularity Color variegation Diameter > 6 mm Evolving
Staging of Melanoma:
Stage I – Localized disease
Stage II – Regional lymph node metastasis
Stage III – Distant metastasis
SOS !!!!!!
a red, velvety plaque or patch with smooth, velvety, or granular surface depressed below the level of the surrounding mucosa
ERYTHROPLAKIA
MRONJs clinical features:
pain
edema
pus
Oral cancer risk factors:
sun workers (pluggers, electricians) HIV alcohol smoking genetic environment unhealthy lifestyle
