Non-odontogenic Tumors Flashcards
4 types of benign bone tumors
- Chondroma
- Osteoma (Gardern’s syndroma)
- Osteoid Osteoma and osteoblastoma
- Desmoplastic fibroma of bone
Origin of chondroma
Chondrogenic tumor arising from remnants of cartilage including Meckel’s coronoid and condylar cartilages
4 general characteristics of chondroma
- More common in short bones of hands and feet, much rarer in the jaws
- Ocurs at any age
- No apparent sex predilection
- Consider the risk of malignant transformation in benign chondromas
4 radiographic features of chondroma
- Occur in the anterior part of the maxilla or in the condylar process
- Well-defined radiolucency in the condyle
- Deformation of the condylar head
- Radiological features suggesting a benign lesion
Composition of osteoma
- Compact bone
- Cancellous bone
- Combination of compact and cancellous bone
5 clinical features of osteoma
- Can occur at any age
- Painless swelling
- Slow growing tumor
- Facial asymmetry
- Mucosa covering the lesion is normal
Effect of osteoma on surrounding structures
Large lesion can displace adjacent soft tissues
Radiographic periphery and shape of osteoma
- Well-defined borders
- Exophytic
- Extanding outward into adjacent soft tissues
Radiographic internal structure of osteoma
Radiopaque lesion (composed of bone)
Location of osteoma (3)
- More commonly in the lingual side of the ramus (i.e. at the angle)
- Condylar and coronoid region
- Paranasal sinus (frontal, ethmoid, maxillary sinuses)
Differential diagnosis for osteoma
- Osteoma does not generally present a problem with diagnosis
- Osteoma involving the condylar head can be difficult to differentiate from:
- Osteochondroma
- Osteophytes
- Condylar hyperplasia
5 aspects of Syndrome de Gardner
- Familial multiple polyposis
- Hereditary condition (AD)
- Multiple osteomas (6 or more is indicative)
- Appear during the second decade
- Can be associated with multiple unerupted supernumary and permanent teeth
- Multiple enostosis
- Multiple polyps of small and large intestine
Location of osteomas of Gardner’s Syndrome (4)
- Frontal bone
- Mandible
- Maxilla
- Sphenoid bones
Why is Garner’s syndrome important to detect early?
- Strong predilection of intestinal polyps to undergo malignant conversion
- Osteomas and enostosis often develop before intestinal polyps, so early recognition of the syndrome can be lifesaving
Difference between osteoid osteoma and osteoblastoma
- Osteoid osteoma < 2 cm
- Osteoblastoma > 2 cm
NOTE: Extremely rare in the jaws
5 clinical features of osteoid osteoma/osteoblastoma
- Slow growing osteogenic tumor
- 80% of OO occur in long bones
- Less than 1% occurs in jaws
- Pain i nthe bone that can be relieved by anti-inflammatory drugs is characteristic
- Swelling
Effect of osteoid osteoma/osteoblastoma on surrounding structures
Sclerotic bone reaction can thickening of the outer cortex by stimulating periosteal new bone formation (thickening of the cortical plate adjacent to lesion)
Radiographic periphery and shape of osteoid osteoma/osteoblastoma
Well-defined sclerotic borders
Radiographic internal structure of osteoid osteoma/osteoblastoma
- Mixed radiolucent/radiopaque lesion
- Radiopaque mass
Location of osteoid osteoma/osteoblastoma
- Most common in the long bones
- May develop in the mandible
4 differential diagnoses of osteoid osteoma/osteoblastoma
- Ossifying fibroma
- Enostosis
- Cementoblastoma
- Complex odontoma
2 benign tumors of neural origin
- Neurofibroma (neurinoma)
- Neurofibromatosis
4 general characteristics of neurofibroma
- Benign tumor arising from neurons and perineural cells (Schwann cells)
- Neurofibroma involved nerve trunks
- Pathognomonic criterion for Neurofibromatosis type 1 (NF-1)
- May also occur as a solitary jaw lesion
4 clinical features of neurofibroma
- Found in young patient
- Association with mandibular nerve may produce pain or paresthesia
- Slow-growing tumor
- Swelling that is firm to palpation (large lesions)
Effect of neurofibroma on surrounding structures
Fusiform enlargement of the canal
Radiographic periphery and shape of neurofibroma
Well-defined sclerotic borders
Radiographic internal structure of neurofibroma
Unilocular and radiolucent
NOTE: Larger lesions may be multilocular
Location of neurofibroma
Most common in long bones. Rarely in jaws
Define neurofibromatosis
- Neurocutanous genetic disorder characterized by light brown skin (“cafe au lait”) spots on the skin and multiple neurofibromas
- Prevalence reported to be 1/3000
- Two variants: NF-1 (generalized; multiple neurofiibromas associated with cranial nerves) and NF-2 (central; 2 neurofibromas centered on affected nerve)
Radiographic appearance of neurofibromatosis
Enlargement of the mandibular canal and mental and mandibular foramina
Benign tumor of vascular origin
Central hemangioma
3 general characteristics of central hemangioma
- Proliferation of blood vessels
- Most often found in vertebrae and skull
- Rarely develops in the jaws
5 clinical features of central hemangioma
- More prevalent in females than in males
- Occurs most commonly in the first decade
- Swelling may or may not be painful
- Pulsating pain
- Bleeding can occur from gingiva around the cervic of the affected teeth
3 effects of central hemangioma on surrounding structures
- Canal enlargement
- Alteration of the normal path of the canal
- Root resorption and displacement
Radiographic periphery and shape of central hemangioma
Well-defined or ill-defined borders -> appearance of malignant tumor
Radiographic internal structure of central hemangioma
Radiolucent
Location of central hemangioma
- Most common in the posterior body of the mandible
- May involve the mandibular canal
2 differential diagnoses for central hemagioma
- Neurofibroma
- Malignant disease (osteogenic sarcoma)
