Malignant Bone Tumors Of The Jaw

Question 1

Benign bone tumors

Answer 1

Osteoblastoma
Osteoma
Osteochondroma

Question 2

Malignant bone tumor

Answer 2

Osteosarcoma
Chondrosarcoma

Question 3

Signs and symptoms of malignancy in the jaw

Answer 3

Paresthesia
Pain
Tooth mobility
Tooth resorption
Rapid growth
Acquired malocclusion
Radiographic changes
Uniformly widened PD membrane space
Ill-defined lesion

Question 4

Unilateral coronoid hyperplasia

Answer 4

Osteochondroma

Question 5

Benign neoplasm forming a bony projection with a cartilagenous cap, with continuity between the marrow cavity of the tumor and underlying bone

Answer 5

Osteochondroma

Question 6

Painless, facial asymmetry, trismus, TMJ dysfunction

Answer 6

Osteochondroma

Question 7

Localization: coronoid process, mandibular condyle

Onset at puberty

Answer 7

Osteochondroma

Question 8

Benign cartilagenous tumor of unknown cause. Rarely seen

Appears as painless, slowly progressive swelling

Answer 8

Chondroma

Question 9

Chondroma that airses in the maxillary region usually found in?

Answer 9

Anterior region, where cartilaginous remnants of development are located

Question 10

Location of mandibular chondromas

Answer 10

Body and symphysis area. Coronoid process and condyle

Question 11

Equal gender predilection

Majority of tumors appear before age of 50

Answer 11

Chondroma

Question 12

Irregular radiolucent. Foci of calcification within the radiolucent lesion

Answer 12

Chondroma

Question 13

__ pharyngeal arch does meckel’s cartilage originate

Answer 13

First

Question 14

A cartilage that forms in the embryonic development of lower jaw

Answer 14

Meckel’s cartilage

Question 15

Well defined lobules of mature hyaline cartilage

Contains single regular nuclei

Answer 15

Chondroma

Question 16

exhibits a heterogeneous pattern with cytologically
atypical and irregularly spaced chondrocytes.

Answer 16

Chondrosaroma

Question 17

Treatment of chondroma

Answer 17

Surgical excision

Question 18

3rd most common bone malignancy after myeloma and osteosarcoma

Answer 18

Chondrosarcoma

Question 19

30 - 60 yo with 75% in men.

1% occur in skeleton

Answer 19

Chondrosarcoma

Question 20

60% occur in maxillofacial region and 40% in mandible

Answer 20

Chondrosarcoma

Question 21

Mandibular chondrosarcoma occus most often in

Answer 21

Premolar and molar region

Symphysis and coronoid process

Question 22

Maxillary chondrosarcoma occurs in

Answer 22

Lateral incisor - canine region

Palate

Question 23

No gender predilection

60yo

Answer 23

Chondrosarcoma

Question 24

Common signs: painless swelling, bone expansion - loosening of teeth or dentures, pain, visual disturbances, nasal signs and headache

Answer 24

Chondrosarcoma

Question 25

Moth-eaten radiolucencies that are solitary or multilocular to diffusely opaque lesions Localized widening of the PDL space

Answer 25

Chondrosarcoma

Question 26

Preferred method to image chondrosarcoma

Answer 26

computed tomography

Question 27

DD of chondrosarcoma

Answer 27

Chondroma Chondroblastic variant of osteosarcoma Chondromyxoid fibroma

Question 28

Have a lobular achitecture Increased number if chondrocytes

Answer 28

Grade 1 - well differentiated chondrosarcoma

Question 29

Enlarged chondrocyte nuclei displaying occasional mitotic figures. Increased cellularity at the periphery of the cartilaginous lobules

Answer 29

Grade 2 - intermediate chondrosarcoma

Question 30

Markedly cellular, often with a spindle cell component. Mitotic figures may be numerous

Answer 30

Grade 3 - poorly differentiated

Question 31

5 year Survival rate and metastasis in chondrosarcoma

Answer 31

GRADE 1 - 78%; 4% GRADE 2 - 53%; 10% GRADE 3 - 22%; 70% - metastasis in lungs

Question 32

Most common primary bone tumor (5%)

Answer 32

Osteosarcoma

Question 33

Exits in other bone disease: paget’s disease, fibrous dysplasia, multiple osteochondromas, osteomyelitis, osteogenesis imperfecta 3-4 onset of symptoms prior to diagnosis

Answer 33

Osteosarcoma

Question 34

Etiology of osteosarcoma Gene that may be altered -

Answer 34

p53 Rb Amet fos sas mdm2 cdk4 c-myc

Question 35

Swelling, pain, pdl invasian, tooth mobility 35 age: range from 8 to 85yo = gender predilection 60 % Mandible > maxilla

Answer 35

Osteosarcoma

Question 36

Osteosarcoma can a,so arise in two cancer susceptibility syndromes __ and __ They sre both inherited and acquired forms of Rb

Answer 36

Hereditaryvretinoblastoma (Rb) and Li-Fraumeni syndrome

Question 37

Comon site of osteosarcoma

Answer 37

Body and angle of mandible, symphysis, ascending ramus, tmj

Question 38

Cardinal sign of malignancy

Answer 38

Paresthesia, caused by compression or infiltration of adjacent nerves by tumor

Question 39

Radiographically, early osteosarcoma shows what characteristics?

Answer 39

Localized swelling in pdl of one or two teeth (due to tumor invasion)

Question 40

Histologic subtype: when malignant cartilage predominates

Answer 40

Chondroblastic osteosarcoma

Question 41

Histologic subtype: when malignant bone and osteoid predominates

Answer 41

Osteoblastic osteosarcoma

Question 42

Histologic subtype: when spindle cells predominate

Answer 42

Fibroblastic osteosarcoma

Question 43

Rare variant, that microscopically, resembles fibrous dysplasia because of the minimally atypical spindle cell proliferation with occasional mitotic figures and bone spicules

Answer 43

Central low-grade osteosarcoma

Question 44

A useful immunohistochemistry marker to identify low grade osteosarcoma

Answer 44

CDK4 AND MDM2

Question 45

Is CDK4 and MDM2 positive in high grade osteosarcoma?

Answer 45

No

Question 46

Most common subtype of osteosarcoma

Answer 46

Chondrobastic osteosarcoma (Maybe misdiagnosed as chondrosarcoma)

Question 47

Treatment of osteosarcoma

Answer 47

Radical surgery, chemo and radio

Question 48

Osteosarcoma that arise at the periphery of bone at the periosteal surface Uncommon neoplasm

Answer 48

Juxtacortical osteosarcoma

Question 49

Peak incidence 39 yo Most common: distal femoral, metaphysis 3:2 female predominance. If jaw, male

Answer 49

Parosteal osteosarcoma

Question 50

long-standing, slow-growing, swelling or palpable mass, often accompanied by a dull, aching sensation Attached to the external surface of bone by a broad sessile base Radiopaque at the base than the periphery

Answer 50

Parosteal osteosarcoma

Question 51

20 yo peak incidence 2:1 male Involve upper tibial metaphysis Very rare

Answer 51

Periosteal osteosarcoma

Question 52

Codman’s triangle

Answer 52

Periosteal osteosarcoma

Question 53

Consistent imagine features, tumor cells producing immature osteod premative invasion, entrapment of healthy host bone

Answer 53

Osteosarcoma

Question 54

Malignant tumor with cartilaginous matrix, entrapped pre-existing bone, lack of neoplastic bone or osteoid formation

Answer 54

Chondrosarcoma

Question 55

Soft tissue mass composed off nodules of cartilage, hyaline or myxoid matrix that may calcify, few mitosis

Answer 55

Chondroma

Question 56

Pedunculated eor broad-based exostosis, cartilaginous cap with a growth plate-like architecture, continuity with underlying bone cortex and marrow

Answer 56

Osteochondroma

Question 57

Osteobladtic riming

Answer 57

Ossifying fibroma Osteoblastoma

Question 58

Associated with gardner syndrome

Answer 58

Osteoma