Odontogenic Neoplasm/ Tumour Flashcards

1
Q

Two types of odontogenic tissue?

A

Mesenchyme

Epithelium

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2
Q

Examples of odontogenic epithelium?

A

RREDO

Oral epithelium
Dental lamina 
Enamel organ 
Reduced enamel epithelium
Rest of Malassez
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3
Q

Examples of odontogenic mesenchyme?

A

PFP

Dental papilla
Dental follicle
Periodontal ligament

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4
Q

What gives rise to radicular cyst?

A

cell rests of mallassez from Hertwigs root sheath

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5
Q

What gives rise to dentigerous cyst?

A

Reduced enamel epitheloum

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6
Q

What gives rise to keratocyst?

A

Dental lamina

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7
Q

What types of pathology does dental lamina give rise to?

A

Ameloblastoma

Keratocyst

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8
Q

How do odontogenic tumours often present?

A

Radiolucent lesions

Most often angle of mandbile

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9
Q

Why do odontogenic tumours present angle of mandible?

A

Remnant of dental lamina

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10
Q

How are odontogenic tumours classified?

A

Benign or malignant

Then epithelium/ mesenchyme or mixed

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11
Q

Example of a benign odontogenic epithelium tunour?

A

Ameloblastoma
Calcifying epithial odontogenic tumour
Adenomatoid O.T

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12
Q

Example benign epithelial/ mesenchyme tumour?

A

Odontoma

Ameloblastic fibroma

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13
Q

Example benign odontogenic mesenchyme tumour?

A

Odontogenic fibroma
Odontogenic myxoma
Cementoblastoma

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14
Q

Is an odontoma a neoplasm?

A

No

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15
Q

Most common odontogenic neoplasm?

A

Ameloblastoma - benign epithelial odontogenic tumour

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16
Q

Most common odontogenic mesenchyme tumour?

A

Myxoma

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17
Q

Most common mixed odontgenic tumour?

A

Calcifying odontogenic cyst - CEOT less rare

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18
Q

What is ameloblastoma?

A

Benign but destructive odontogenic epithelial tumour

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19
Q

Where do ameloblastoma present?

A

Most common site = angle of mandbile

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20
Q

Epidemiology of ameloblastoma?

A

Age 30-50

More common black population

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21
Q

How do ameloblastoma present clinically?

A

Often asymptomatic

Can get bucco-lingual expasnion

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22
Q

How does ameloblastoma present on radiograph?

A

Well defined, radiolucent lesion angle of mandible
Uni or multi-locular appearance
Not cortication
Effect adjacent structures - displacement/ resorption

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23
Q

Where do ameloblasts arise from?

A

Dental lamina

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24
Q

What are the 3 subtypes of ameloblastomna?

A
  1. conventional = intra-osseous
  2. unicystic = intra-osseous
  3. peripheral = extra-osseous
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25
Two types of conventional ameloblastoma?
Follicular Plexiform Many tunours contain both patterns
26
What would see in histology of follicular ameloblastoma?
Islands of epithelial tumour, surrounded in fibrous stroma Epithelium resembles enamel organ Columnar ameloblast like cells at periphery of islands Stellate reticulum like area in centre islands Cysts forming within islands
27
What would see in histology of plexiform ameloblastoma?
Columnar ameloblast-like cells forming cords No/ little stellate-reticulum Cysts form within stroma
28
Types of unicystic ameloblastoma?
Luminar | Intraluminar
29
Treatment of unicystic ameloblastoma?
True unicystic ameloblastoma can be enucleated
30
Management of conventional ameloblastoma?
Requires excision w/ margins | Reconstruction/ bone grafts
31
What are mutations causing ameloblastoma?
Mandible - BRAF oncogene | Maxilla - SMO oncogene
32
What is AOT?
Adenomatoid odontogenic tumour - benign
33
Key feature of AOT?
Benign, not expansile and not destructive
34
Who see AOT?
Age 10-20 | F>M
35
Where see AOT?
Often in maxilla | Can present radiolucency around crown of tooth
36
Differential AOT?
Dentigerous cyst
37
What see radiograph AOT?
Pericoronal radiolucecny - on or around ACJ | See background calcifiication = snow storm
38
Histology AOT?
Duct-like structures | Calcification realted dentinoid calcified material = snow strom
39
What can calcifying epithelial odontogenic tumour also be called?
Pindborg tumour
40
Are CEOT destructive?
Benign and locally destructive
41
Epidemiology CEOT
Age 10-60 | Most in mandibular molar region
42
What see radiograph CEOT?
Radiolucency with speckled calcification | More calcification w/ age of lesion
43
Histology of CEOT?
Pleomorphic epithelium w/ dentinoid calcifications Enamel matrix - may calcific Cuboidal cells w/ prickles Variation nuclear size/ shape
44
What is ameloblastic fibroma?
Benign odontogenic mixed epithelium/ mesenchyme tumour
45
Epidemiology ameloblastic fibroma?
Less 20 years Often mandible 80% associatiated unerupted tooth
46
How does ameloblastic fibroma present?
Well-defined radiolucency
47
Histology ameloblastic fibroma?
Branching cords and islands of epithelium - resemble enamel organ/ dental lamina Fine cellular stroma Possible see dental card tissue Columnar ameloblast like cells
48
What is a dentinogenic ghost cell tumour?
Benign odontogenic mixed epithelium/ mesenchyme tumour
49
Epidemiology of dentinogenic ghost cell tumour?
Very rare Often 40-60yrs M>F
50
How to dentinogenic ghost cell tumours present?
Radiolucency - may have calcification | Large and expansile
51
Histology dentiongenic ghost cell tumour?
Epithelium resembling ameloblastoma Ghost cells and dentine Ghost cells - no nuceli
52
What is odontome?
Benign odontogenic mixed epithelium/ mesenchyme tumour
53
Epidemiology odontome?
Developmental abnormalities that grow within growth period of developing dentition - up to 20 yrs
54
Where to odontomes present?
Mandible or maxilla
55
How to odontome present?
Radiolucency containing tooth-like structure
56
Two types of odontome?
Compound and complex
57
What compound odontoma?
See in maxilla > mandible See in incisor/ canine regio Small and non-aggressive Collection of denticles
58
What odontome is more common?
Compound
59
What is complex odontome?
Seen in mandible > maxilla Premolar/ molar region Often missing tooth Fused mass of haphazardly arranged tooth tissue
60
Why are complex odontome prone to infection?
Irregular form can be focus for bacteria
61
What is myxoma?
Benign odontogenic mesenchyme tumour
62
Is myxoma destructive?
Yes, locally
63
Where do myxoma present?
Mostly in mandible as slow growing, painless swellings
64
How do myxoma present radiographically?
``` Uni or multi-locular radiolucecny Well defined Partly corticated Soap-bubble appearnace Root displacement/ resoprtion ```
65
Histology myxoma?
Triangular/ stellate cells in loose myxoid stroma | Loose connective tissue w/ struts of bone separating compartments
66
What are types odontogenic fibroma?
Can be central (arise in bone) or peripheral (arise in gingivae)
67
How does odontogenic fibroma present radiograph?
Unilocular radiolucency due mature fibrous tissue
68
Where does cementoblastoma usually present?
Usually mandible - molar teeth | Present radiopaque lesion attached to tooth root
69
How does cementoblastoma present histologically?
Sheets of cementum and osteoid in mosaic pattern