Odontogenic Neoplasms (3) Flashcards
What are the three categories of odontogenic neoplasms?
- Tumor of odontogenic epithelium (enamel organ)
- Mixed tumors (odontogenic epithelium and odontogenic ectomesenchymal)
- Odontogenic ectomesenchymal (dental papilla)
What are the three neoplasms of odontogenic epithelium?
- Ameloblastoma
- Adenoid odontogenic tumor
- Calcifying epithelial odontogenic tumor
What are the three odontogenic neoplasms of mixed origin?
- Ameloblastic fibroma
- Ameloblastic fibro-odontoma
- Odontoma
What are the two neoplasms of odontogenic mesenchymal origin?
- Odontogenic myxoma
2. Cementoblastoma
T/F: Ameloblastomas are benign, painless tumors.
True
What is the most frequent tumor of odontogenic origin?
Ameloblastoma
T/F: Ameloblastomas will often perforate the bone.
False
Will cause dramatic expansion of bone
What is the most common location for Ameloblastomas?
Posterior mandible
T/F: Ameloblastoma radiolucencies are often described as “soap bubble” or “honeycomb”.
True
T/F: Enamel is produced by ameloblastoma cells.
False
Resemble ameloblasts but no enamel is produced
What attributes to the recurrence of ameloblastomas?
Tumor often infiltrates bony trabeculae
What are the two common histopathological patterns seen in ameloblastomas?
Follicular and plexiform
Ameloblastomas are seen as __________ showing cuboidal or columnar cells at the periphery.
Tumor islands
T/F: Ameloblastomas have cells with nuclei polarized away from the basement membrane.
True
Reverse polarization
What are the treatment options for an ameloblastoma?
Small - aggressive curettage or small en bloc resection
Large - large en bloc resection or segmental resection
What is the prognosis of an ameloblastoma?
Guarded
Simple curettage recurrence 50%-90%
Resection recurrence 15%
Rare malignant transformation
What is a peripheral ameloblastoma?
Soft tissue variant of an ameloblastoma
Seen as gingival bumps
T/F: Peripheral ameloblastomas will be seen as a radiolucency on a radiograph.
False
No radiographic findings
What is the treatment/prognosis for peripheral ameloblastoma?
Biopsy/local excision
Limited recurrence
______________ is an asymptomatic tumor of odontogenic epithelium often seen in patients under 20 y.o.
Adenomatoid odontogenic tumor (AOT)
T/F: Odontogenic myxomas are sometimes seen in bones other than the jaw.
False
Only in the jaw bones
T/F: Odontogenic myxomas can have a soap bubble radiographic appearence.
True
Odontogenic myxoma and ameloblastoma
What is a good way to differentiate an ameloblastoma and odontogenic myxoma based off of radiographs?
Odontogenic myxoma has thin wispy trabeculae at right angles
T/F: Odontogenic myxomas can cause root displacement and resorption.
True
____________ is characterized histopathologically by spindle-shaped or stellate-shaped fibroblastic cells set in a myxoid background.
Odontogenic myxoma
What can lead to recurrence of odontogenic myxoma?
Lesional proliferation tends to infiltrate adjacent bony trabeculae
What is the treatment/prognosis for odontogenic myxomas?
Small - curettage
Large - En bloc or segmental resection
Good; can recur
_____________ is a tumor of odontogenic ectomesenchyme that is often seen in patients under 25 y.o. In the mandibular first molar region.
Cementoblastoma
T/F: Cementoblastomas will often cause pain and swelling.
True
What is the radiographic appearance of a cementoblastoma?
Well-circumscribed radiopaque mass with fine radiolucent border fused to the root
What is a major distinguishing histopathological feature of a cementoblastoma?
Fused to the root
Resembles cementum
What is the treatment/prognosis for cementoblastoma?
Surgical extraction of tooth with lesion
RCT tooth and root amputation of affected root and lesion
Excellent
Where is the most common place to see an adenomatoid odontogenic tumor (AOT)?
Anterior maxilla on a female
Also 75% associated with impacted tooth
T/F: An AOT will sometimes have radiopaque flecks seen within the radiolucency.
True
What are the histopathological features of an AOT?
Well-developed capsule
Swirling spindle-cell nests
Possible basophilic calcified material
What is the treatment/prognosis of an AOT?
Enucleation
Excellent
What is another name for a Calcifying epithelial odontogenic tumor (CEOT)?
Pindborg tumor
What is the histogenesis of a CEOT?
Stratum intermedium
What is the most common location for a CEOT?
Posterior mandible
What are some radiographic features of a CEOT?
Radiolucency with possible radiopaque flecks in a “driven snow” pattern
What is the treatment/prognosis for CEOT?
Conservative excision
Good
T/F: An ameloblastic fibroma involves both epithelial and ectomesenchyme cells.
True
T/F: Ameloblastic fibromas are most often seen in adults.
False
1st-2nd decade
Where is an ameloblastic fibroma most likely to be seen?
Posterior mandible
What does an ameloblastic fibroma look like histopathologically?
Myxoid connective tissue with strands and islands of epithelium
What is the treatment/prognosis for an ameloblastic fibroma?
Aggressive curettage
Good
What is the average age of a patient who develops an ameloblastic fibro-odontoma?
10 y.o.
T/F: Ameloblastic fibro-odontomas are seen more often in the posterior mandible.
False
Equal maxilla and mandible
______________ will be seen with varying amounts of calcifying material the same density of the tooth. It is typically associated with failed tooth eruption.
Ameloblastic fibro-odontoma
What is the treatment/prognosis of ameloblastic fibro-odontoma?
Conservative excision
Excellent
What are the two forms of odontomas and their likely locations?
- Compound - anterior jaw
2. Complex - posterior jaw
Odontomas are not true neoplasms, but rather an ______________.
Odontogenic hamartoma
What age is the patient most likely to develop odontoma?
1st-2nd decade
What is the radiographic appearance of a compound and complex odontoma?
Compound - anterior jaw, collection of small malformed teeth surrounded with radiolucent rim
Complex - posterior jaw, calcified mass surrounded by narrow radiolucent rim
*both often overly an impacted tooth
T/F: A complex odontoma is a formation of multiple small malformed teeth.
False
Compound
What is the treatment/prognosis for odontoma?
Enucleation
Excellent
