Neoplasms Flashcards
Hallmarks of malignant transformation
Anaplasia
Enlarged nuclei and cells
Large prominent nucleoli
Increased nuclear to cytoplasmic ratio
Hyperchromatism
Pleomorphism
Dyskeratosis
Increased mitotic activity
Abnormal mitotic figures
Loss of polarity
Drop shaped reteridges
Dysplasia
Destruction of bone giving MOTH EATEN radiolucency with ill defined margins
Malignant lesions radiographically
Most common type of oral cancer
SCC
Most reliable histo criteria for diagnosis of oral SCC
INVASION
Clinical features of SCC
Indurated ulcers with rolled borders
Exophytic - fungating, papillary and verruciform)
Endophytic - invasive
Leukoplakia
Erythroplakia
Mixed red and white
Loosening of teeth
Parasthesia
Most common intraoral site for SCC
posterior lateral border of tongue
Syndrome associated with SCC of tongue
Plummer vinson syndrome
Metastasis of SCC of lower lip
Submental and lymph nodes
Metastasis of SCC of tongue
Ipsilateral Lymphnodes of the neck
Submandibular
Jugulodiagstric
Second most common intraoral site of SCC
Floor of the mouth
SCC of floor of the mouth metastatic location
Submandibular lymphnodes bilaterally
Most commonly occurs in the ant segment on either side of the midline near the orifices of the salivary glands
SCC of buccal mucosa
Along the plane of occlusion
More common in mandible
Posterior
Least common site of SCC
Nasopharynx
causes of oropharyngeal SCC
Exposure to carcinogens
HPV type 16 and 18
Oropharyngeal carcinoma favoured sites?
Soft palate
Base if tongue
Tonsillar region
Post pharyngeal wall
Metastases to the jaws most commonly originate from primary carcinoma
Adenocarcinoma of breast
Kidney
Colon
Prostate
Thyroid gland
Type of spread of carcinoma to the jaw?
Hematogenous route
Metastatic jaw lesions in oral cavity?
Most common site angle/body of mandible
Bone pain
Loose teeth
Lip parasthesia
Bone swelling
Gingival mass
Pathologic fracture
Most common site for metastatic jaw lesion for oral soft tissues
Gingiva
Tongue
Low grade variant of oral SCC
Verrucous carcinoma
Whitish diffuse
Well demarcated
Asymptomatic
Thick plaque with papillary or verruciform surface projection in mandibular vestibule
Buccal mucosa gingiva tongue and hard palate
Verrucous carcinoma
Most common skin cancer
Basal cell carcinoma
Features of basal cell carcinoma
Affects white adults
Males
Excessive exposure to the sun or to xrays
Non healing indurated chronic ulcer on the nose
Surgery for basal cell carcinoma
MOHS micrographic surgery
Deadliest form of skin cancer
Melanoma
Involving melanocytes
Common site for melanoma intraorally
Palate
Maxillary gingiva
Alveolar ridge
Types of melanoma
Superficial - most common, flat irregular shape
Nodular melanoma - raised area, poor prognosis
Lentigo maligna melanoma - hutchinson freckle, sun damaged skin on the face neck arms
Acral lentiginous melanoma - most common form of melanoma in blacks and oral cavity - genetic mutations
A B C D E of melanoma
A - asymmetry
B - border irregularity
C- color variation
D - diameter of greater than 1/4 inch
E - evolving
Patient is presented with pigmented lesion on palate that has changed in size and colour over time has irregular borders and asymmetrical
Melanoma
Carcinoma occurs rarely intraorally
BASAL cell carcinoma
Least common carcinoma
Melanoma
Most fatal carcinoma
Melanoma
Disease of abnormal plasma cells that most often build up in the bone marrow
Multiple myeloma
Commonest site for multiple myeloma intraorally
Molar ramus
Swelling pain loose teeth parasthesia PUNCHED OUT radiolucency on the lateral skull radiograph
Multiple myeloma
Plasma cell myeloma
Localised form of multiple myeloma
Plasmocytoma
Waldeyers ring
Ring of lymphatic tissue formed by the 2 palatine tonsils
Pharyngeal tonsil
Lingual tonsils
Types of lymphoma
Hodgkins
Non hodgkins
Burkitts
Malignancy of B lymphocytes characterized by the presence of REED STERNBERG CELLS
Hodgkins lymphoma
Painless mass or firm rubbery non tender cervical and supraclavicular lymphnodes followed by weightloss fever night sweats and pruritis
Hodgkin lymphoma
Large group of lympho prolifertive disorders classified as of B cell or T cell origin
Mainly B lymphocytes
Non Hodgkin’s lymphoma
Common intraoral site for non hodgkin lymphoma
Buccal vestibule
Post hard palate
Gingiva
Causative agent for burkitts lymphoma
Epstein barr virus
High grade malignancy of B lymphocytes origin which is very aggressive and grows rapidly to CNS
Burkitts lymphoma
Forms of burkitt lymphoma
Classic endemic - involves maxilla post segment in young males
Sporadic - abdominal mass
Immuneodeficiency associated burkitt lymphoma - allografts HIV congenital
Oral manisfestations of burkitt lymphoma
Facial swelling
Proptosjs
Tooth mobility
Premature exfoliation
Hemorrhagic soft tissue nodular masses
Starry sky pattern
Burkitts lymphoma
Most common primary bone tumors
Osteosarcoma
Intraoral sites for osteosarcoma
Mandible : body of the mandible
Maxilla - alveolar ridge and antrum
Symmetrical widening of the PDL space
Radiopaque and radiolucent or mixed ill defined borders
SUN BURST app of periosteal
Root resorption
Osteosarcoma
Round cell sarcoma
Ewing sarcoma
Onion skin pattern
Periosteal reaction seen in
Ewings sarcoma
Osteomyelitis
Malignant neoplasm of endothelial cells characterized by vascular proliferation commonly found in AIDs associated with human herpes 8
Kaposis sarcoma
Common site intraorally for kaposi sarcoma
Palate
Gingiva
Buccal mucosa
