fml giannina Flashcards
cemento-ossifying fibroma (COF)
1) age
2) sex predilection
3) assym?
4) location?
5) radiogrph?
6) neoplasm?
7) displace teeth?
8) D/D
9) clinical symptoms
10) surgical presentation
11) histo
12) txt? recur?
1) 3-4th decade
2) 5F : 1M
3) assymptomatic IF SMALL
4) MN in PM/M
5) Well demarcated, unilocular, expansible/bowing of jaw if large, and radiolucent or mixed (more cementum=more opaque)
* ALWAYS has lucent border*
6) true neoplasm, monoclonal set of cells
7) NO
8) Cementoblastoma (MN 1M) but you know it’s not since it’s not attached to a tooth
9) Overlying mucosa is eroded and massively expansible in nature
10) Its characeter that COF comes out as a single mass, and a potato like mass (incisional biopsy tunrs into excisional)
11) potato like mass, CT and interspersed bone/cementum
12) Enucleation, and no, we do not expect recurrence
Fibrous Dysplasia (FD)
1) what is it?
2) 80-85% location?
3) high risk of?
4) radiograph
5) craniofacial FD?
6) age?
7) sex?
8) clinic?
9) % of FD polystotic cases?
10) histo
11) background stroma
12) txt and recur
13) malignant transform?
1) one disorder where fibrous tissue develops in place of bone -NOT a true neoplasm, a developmental tumor
2) Monostotic, jaws (MX) and long bones
3) bone fracture, hockey stick legs
4) Ground glass or orange peal radiopacity, poorly demarcated, no lucent border
5) not mono or polystatic bc no contagious bone in FD of face
6)1- decade
7_ F=M
8) painless swelling
9) 15-20%
10) Chinese characters appearance, NO osteoblasts in periphery, massive amoutns of fibrous tissue with immature trabeculae with no specific orientation
11) Background stroma is uninflamed; Will be replaced by cortical or llameler bone as lesion matures
12) No treatment unless there is severe cosmetic deformities since it will be recurrent 25-50%
13) RARE, most cases follow radiation txt
What are the two types of polystotic fibrous dysplasia?
1) Jaffe – multi bone involvement, skin
2) Mccune Albright – café au liat macules, ENDOCRINE hyperfunction, pituitary adenoma
Cemento-Osseous Dysplasia
1) neoplasm?``
2) location
3) etiology
1) no
2) tooth bearing areas of the jaw in ONLY DENTATE patients
3) reactive, unknkown pathogenesis
Types of Cemento-Osseous Dysplasia? Do they look different in hito?
Type determined by location/extent --Periapical --Florid --Focal Histo looks the same
Periapical Cemento-Osseous Dysplasia (PCOD)
1) occurs in? sex, age
2) lamina dura
3) radio
4) tooth vital?
5) D/D
6) txt
1) anterior MN, AA, 14F:1M, 30-50 yrs
2) Lamina dura is in tact with no widening due to the fact that this is not proliferative
3) Starts out as a radiolucent lesions that is well corticated but over time the lesion will become radiopaque
4) VITAL TOOTH
5) COF (PCOD does NOT cause expansion and has vital teeth with no resorption, multi fragments to remove)
6) none, multiple fragments if removed
Focal Cemento-Osseous Dysplasia (FCOD)
1) sex, age, location
2) location
3) txt and radio
1) 80% female, white, 4-5th decade
2) post MN, asymptomatic, no expansion
- -NOT in anterior
3) must biopsy to rule out COF bc opaque with lucent border
Florid Cemento-Osseous Dysplasia (FOD or FCOD)
1) defining feature
2) sex, age, location
3) asym or sym?
4) radio
5) D/D
6) Associated with?
7) txt
1) bilateral AND multiple quadrants
2) young AA females
3) asym unless mucosa isn’t intact- need good hygeine, possible but unlikely expansion
4) cotton-wool
5) Look like osteomas but these do not have the radiolucent rim
6) Traumatic bone cysts
7) Antibiotics with debridement if s2nd infected
Osteoid Osteoma AND Osteoblastoma
1) histo? confused with?
2) benign or malignant?
3) differenciate the two?
4) commonality?
5) age and sex
6) cytokinetic tool
7) txt
8) recur
9) malignant transform
1) Immature osteoid and trabeculae of bone with a bluish look to it, fibrovascular stroma, basophilic
* *Osteoblasts look dysmorphic so it can be confused with osteosarcoma
2) benign
3) only by size, site and symptoms (histo and radio the same)
4) rare <1% of primary bone tumors
5) 11-29 yrs and 2M : 1F
6) FOS and FOSB gene rearrangements, chromosome 19 - distingushed from every other LESION and osteosarcoma
7) local excision curettage
8) Yes, go back and do another curettage
9) Reported but not very common
Osteoid Osteoma
1) size
2) location
3) charactistic? why and relieved by?
4) radio
5) types
6) most common site
7) histo
8) txt
1) <1.5cm or less than 2
2) long bones ( femur, tibia, phalanges)
3) nocturnal pain that is relieved by aspirin - no prostaglandins produced
* *Osteoblastoma also causes pain, which means tumor does not produce prostaglandins *
4) Well circumscribed radiolucency with a central radiopacity and reactive sclerosis
5) periosteal and endosteal (contained within bone)
6) paranasal sinuses
7) compact dense bone (cancellous) trabeculae of bone and fibro–fatty marrow with osteoblasts in periphery
8) no need to txt but excision
Osteoblastoma
1) size
2) location
3) pain?
1) >1.5cm or greater than 2
2) Vertebral column, femur, tibia, mandibula
3) Yes, not relieved with a aspirin since prostaglandins not produced
Gardner Syndrome (GS)
1) what is it?
2) genetic?
3) location
4) confused with
5) complications
6) main complication
7) txt
1) type of familial adenomatous polyp disease that is AD that presents with polyps, epidermoid cysts, as well as multiple osteomas of the jaw
2) autosomal dominant on chromosome 5
3) any bone with limited growth
4) Confused with florid cementoosous dyplasia, but know its not it since there is no radiolucent rim - cotton roll appearance - remember, osteomas are totally radiopaque
5) -50-60% EPIDERMOID benign cysts
- DERMOID tumors in 15-30%
- 85% ocular congenital hypertrophic retinal pigment epithelium
- oral: 35% impacted/supernumerary teeth and 10% odontomas
6) *GI polyps which 50% become malignant by 30yrs
7) Prophylactic colectomy to prevent the development of adenocarcinoma, and genetic counseling
Central Giant Cell Granuloma (CGCG)
1) what is it?
2) neoplasm?
3) location? most common?
4) age and sex?
5) radio
6) unique bc?
7) D/D
8) teeth vital
9) true granuloma?
10) histo
11) Why do we see a brown globular material?
12) txt and recur
1) a reactive, benign, non neoplastic lesion of the jaw
2) No
3) Post MN and ascending ramus- typically crosses midline 70% MN most common
4) 2-4 decade and Female
5) Unilocular radiolucent, become multilocular over time, B-L expansion with thinning of the cortex -MACHO
6) crosses midline
7) GOC bc it also crosses midline
- - Aneurysmal Bone Cyst (ABC)
- - Brown Tumor of hyperparathyroidism look the same
- - Giant cell tumor of bone - does not occur in jaws, occur sin distal femur proximal tibia
8) should be; depends on resorption
9) no
10) Granulation tissue (blood vessels and fibroblasts), Large multinucleated osteoclast giant cells, endothelial and blood cells
11) There are blood cells due to endothelial cells, and this leads to the break down of heme leading to the deposition of brown globular material
12) curettage, calcitonin injections, interferon alpha and 15-20% recur
Granulation tissue means?
blood vessels and fibroblasts
Hemangioma of Bone (Vascular Malformation)
1) what is it?
2) neoplasm
3) location
4) arteries or veins?
5) age and sex
6) clinical signs
7) radio
8) resorption?
9) histo
10) txt
11) D/D
1) vascular malformation that occurs within the bone
2) not a neoplasm
3) skull, vertebra, jaw-MN mostly)
4) both
5) 2-3 decade and Females
6) Pain, swelling, mobility, sulcular bleeding and bruit
7) radiolucent and multiocular (MACHO) with a sunburst pattern in response to expansion of bone
8) yes plus expansion
9) cavernous (large) or capillary (small)
10) Pretreatment aspiration FIRST - do not want to embolize the lesion so want to aspirate first
11) aspirate + blood= vascular malfomation
- straw colored fluid= mandibular cyst
- cheesey/white keratin= CGCG or OKC
- –also, CGCG will have large central cells instead of spaces, no bruit, doesn’t happen in skull/vertebra
