Mixed radiolucent radiopaque lesions Flashcards
Ossifying fibroma
Benign odontogenic tumor
o Consists of (2) that contains varying amounts of —
o speed, symptoms, etc
o
o Age
o Gender
highly cellular, fibrous tissue; mineralized tissue (abnormal bone and/or cementum)
Slow growing, asymptomatic (at the time of discovery) and expansile.
Facial asymmetry (occasionally)
Young adults (20-30 years of age)
Females> males
Ossifying fibroma
Juvenile ossifying fibroma is a
very aggressive form of ossifying fibroma that
occurs in the first 2 decades of life (more expansile and rapid growth)
Ossifying fibroma
Imaging features:
oMost commonly in the —.
o If in the mandible:
o If in the maxilla:
oPeriphery:
mandible
Inferior to the premolars and molars
it occurs most often in the canine and superior to the inferior alveolar canal.
fossa and zygomatic process of the maxilla area.
Well-defined and the cortical borders may
appear thickened.
Ossifying fibroma
oEffects on the surrounding tissues:
(4)
o Concentric growth (equal in all directions)
o Thinning and displacement of the bone cortices (remaining
intact)
o Teeth displacement (missing lamina dura)
o Displacement of the IAC and teeth. Root resorption may occur.
Ossifying fibroma
The internal pattern may be very similar to
fibrous dysplasia. One
distinguishing feature that may be present is a soft tissue capsule
at the periphery not seen in fibrous dysplasi
Ossifying fibroma
oInternal structure:
Mixed radiopaque-radiolucent. Could be
totally radiolucent. The amount of mineralized tissue will
determine the amount of radiopacities
Ossifying fibroma
Treatment
(2)
oEnucleation or resection
oUnlikely recurrence
Garre’s osteomyelitis
o What?
o Hypothesis:
Atypical chronic osteomyelitis with prominent periosteal reaction
Initiated by
bacterial infection but after time the infection resolves but the bone inflammation persists
(usually no bacteria detected at the time of the culture)
Garre’s osteomyelitis
o Affects
oMost common site in the head and neck is the
oMay cause — and — is uncommon. (3) may be present
children, mean age of 12 years (below 30). Slight male predominance
mandible
facial asymmetry; pain; Fever, lymphadenopathy, and leukocytosis
Garre’s osteomyelitis
Management:
(2)
o Root canal treatment or extraction
o Surgical
Osteosarcoma
oMalignant neoplasm of — in which — is produced by the malignant cells. Rare
on the jaws (–% of all osteosarcomas)
osteoblasts
osteoid
7
Osteosarcoma
o gender and age
o symptoms
o where
o reaction
Male : female 2:1. Peak in the fourth decade.
Rapid enlarging swelling, pain, tenderness, erythema of the overlying mucosa, ulceration,
loose teeth, non healing extraction site, epistaxis, hemorrhage, nasal obstruction,
exophthalmos, trismus, parethesia and blindness.
Mandible more affected than maxilla, mostly posterior areas.
Sunray periosteal
Osteosarcoma
o borders
We may see irregular
oInternal structure:
Poorly defined borders and no cortication. Cortical destruction may be seen (soft tissue
invasion).
widening of the PDL.
radiolucent, radiopaque, mixed. Will depend on the ability to produce bone.
Osteosarcoma
Management:
o Surgery, radiation therapy, and
chemotherapy alone or in
combination.
Chondrosarcoma
oChondrosarcoma is a malignant tumor of — origin that produces —. Rare on the jaws (–% of all chondrosarcomas)
mesenchymal
cartilage
10
Chondrosarcoma
o age gender
o where
oThe tumors are covered with normal overlying skin or mucosa unless
Occur in any age (mean age, 47 years). Males and females affected equally.
Affects maxilla and mandible equally (in areas where cartilage may be present)
secondarily ulcerated.
Chondrosarcoma
oPatient may have a
May be
painless hard mass of relatively long duration (slow growing).
well defined and corticated at times (this may be misleading to think it may
be a benign entity)
Chondrosarcoma
oIf occurring in the TMJ: (3)
pain, trismus and/or abnormal joint function
Chondrosarcoma
Internal Structure:
o Internal calcifications:
o Usually exhibit some form of internal calcification, giving them a mixed
radiolucent and radiopaque appearance. The internal pattern may be
quite variable.
areas of unaffected bone or produced by the
malignant cells
Chondrosarcoma
Management:
(1)
o Surgical resection.
Calcifying Epithelial Odontogenic
Tumor (CEOT)
o AKA:
o %
o gender, race
o age
o Produce a — substance.
o usually the only sign…
o where
o periphery
Pindborg Tumor
Rare (1% of benign odontogenic tumors)
Men > women, African Americans
8-92 years of age. Mean 42 years of age
mineralized
Jaw expansion, hard on palpation
Mandible > maxilla (2:1). Premolar-molar area (52% association with the
crown of an unerupted/impacted tooth)
Well-defined and corticated periphery. Cortical displacement
Calcifying Epithelial Odontogenic
Tumor (CEOT)
(3)
o May be unilocular or multilocular
o Tooth displacement
o Prevention of eruption
Calcifying Epithelial Odontogenic
Tumor (CEOT)
Treatment
o Local resection
Calcifying Odontogenic Cyst (COC)
Clinical/Radiographic Features:
o AKA: Gorlin cyst.
o %
o periphery
o RO, RL, mixed?
o symptoms (4)
oCan
Rare (<1% of jaw lesions)
Well defined, corticated and can be uni or multilocular.
Can be totally radiolucent or present internal calcifications (50%)
Asymptomatic swelling, loosening of teeth or incidental finding.
Slow growing.
resorb roots and displace teeth.
Calcifying Odontogenic Cyst (COC)
o —% is pericoronal to an unerupted
or impacted tooth (mostly when in the
anterior area)
20-50
Calcifying Odontogenic Cyst (COC)
where
age
oAnterior>Posterior
o 75% anterior to 1st molar
oWide age range (average teens and
young adults)
Calcifying
Odontogenic Cyst (COC)
Treatment:
o
Enucleation
