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Oral Path 3 > odontogenic neoplasms > Flashcards

odontogenic neoplasms Flashcards

1
Q

Ameloblastoma benign or malignant?

A

benign, but aggressive

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2
Q

Ameloblastoma orgin

A

odontogenic epithelial origin

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3
Q

Ameloblastoma Microscopically, cells resemble

A

the ameloblasts of the enamel organ, but no enamel is produced

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4
Q

whats the most common ondontogenic neoplasm

A

ameloblastoma

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5
Q

Ameloblastoma seen when

A

wide age range 30-70’s

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6
Q

Ameloblastoma makes up ___% of oral pathology biopsy

A

.2%

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7
Q

Ameloblastoma where

A

Most (80-85%) occur in the mandible, usually the molar-ramus region

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8
Q

Ameloblastoma 20% associated with what

A

impacted tooth

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9
Q

Ameloblastoma growth

A

grows slowly, destroying tissue, but usually expanding rather than perforating bone

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10
Q

Ameloblastoma clinical

A

Typically asymptomatic except for swelling

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11
Q

Ameloblastoma radiographic

A

A small lesion usually presents as a unilocular radiolucency with well-defined borders
As the lesion progresses, the classic multilocular expansile radiolucency frequently develops

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12
Q

Ameloblastoma (desmoplastic variant)

A

Distinctive radiologically as well as histologically
Radiographs usually show a poorly demarcated radiolucency with numerous radiopaque flecks
Similar in appearance to benign fibro-osseous lesion

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13
Q

Ameloblastoma patterns

A

follicular and plexiform

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14
Q

Ameloblastoma histo

A

Small tumor islands which show cuboidal or columnar cells at their periphery
The center of the tumor islands is composed of loosely arranged polyhedral epithelial cells that resemble stellate reticulum

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15
Q

Ameloblastoma trt

A

en bloc resection

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16
Q

Ameloblastoma prognosis

A

guarded

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17
Q

Ameloblastoma recurrence rates

A

With simple curettage, recurrence rates reported to be 50-90%
Even with marginal resection, recurrence rates up to 15%

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18
Q

Ameloblastoma, maxilla or mandible require more aggressive trt

A

maxilla

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19
Q

Peripheral Ameloblastoma

A

asymptomatic gingival mass in a middle-aged adult, usually mandible

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20
Q

Peripheral Ameloblastoma size

A

Typically less than 2 cm in diameter

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21
Q

Peripheral Ameloblastoma trt and reoccurrence

A

Important to note that this is an innocuous lesion that can easily be cured by local excision, little tendency to recur

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22
Q

Calcifying Epithelial Odontogenic Tumor

A

Rare odontogenic epithelial neoplasm initially described by Pindborg in 1956

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23
Q

CEOT (Pindborg Tumor) histo, derived from what

A

stratum intermedium

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24
Q

CEOT (Pindborg Tumor) who and when

A

Mean age at diagnosis - 40 years, with no sex predilection

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25
Q

CEOT (Pindborg Tumor) where

A

Most arise in the posterior mandible

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26
Q

CEOT (Pindborg Tumor) clinically

A

Asymptomatic; swelling may be noted

50% associated with an impacted tooth

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27
Q

CEOT (Pindborg Tumor) radiographically

A

Diffuse or well-circumscribed radiolucency unilocular when small
With growth, lesion may become multilocular
Radiopaque flecks often develop as lesion enlarges

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28
Q

CEOT (Pindborg Tumor) histo

A

Sheets or strands of polyhedral epithelial cells with eosinophilic cytoplasm
The nuclei are frequently pleomorphic, but mitoses are rare

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29
Q

CEOT (Pindborg Tumor) major histo characteristics

A

amyloid material that calcifies, forming lamented structures called Liesegang rings

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30
Q

CEOT (Pindborg Tumor) trt

A

Conservative excision with peripheral ostectomy

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31
Q

CEOT (Pindborg Tumor) recurrence rate

A

15% recurrence rate

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32
Q

Adenomatoid Odontogenic Tumor who and when

A

Usually arises in a younger patient, mean age - 18 years, with 75% under 20 years of age
females

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33
Q

Adenomatoid Odontogenic Tumor where

A

maxillary more

75% in anterior

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34
Q

Adenomatoid Odontogenic Tumor 75% associated with _____ teeth

A

impacted

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35
Q

Adenomatoid Odontogenic Tumor clinical

A

asymptomatic

sometimes swelling

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36
Q

Adenomatoid Odontogenic Tumor radiographically

A

Well-circumscribed unilocular radiolucency that may contain radiopaque flecks
Separation of roots or displacement of adjacent teeth occurs frequently

37
Q

radiographic features that distinguish Adenomatoid Odontogenic Tumor from dentigerous cyst

A

When associated with an impacted tooth, the lesion often extends apically beyond the cemento-enamel junction

38
Q

Adenomatoid Odontogenic Tumor histo

A

Well-encapsulated lesion

The tumor cells form swirling spindle-cell nests with duct-like structures of varying sizes

39
Q

Adenomatoid Odontogenic Tumor histo feature that sometimes need to be seen

A

Foci of basophilic calcified material may also be seen

40
Q

Adenomatoid Odontogenic Tumor trt

A

enucleation

41
Q

Adenomatoid Odontogenic Tumor prognosis and recurrence

A

excellent

rare

42
Q

Ameloblastic Fibroma who and when

A

younger patients in first two decades of life

43
Q

Ameloblastic Fibroma where

A

posterior mandible (70 percent)

44
Q

Ameloblastic Fibroma clinically

A

small lesions are asymptomatic, larger ones produce painless swelling

45
Q

Ameloblastic Fibroma radiographic

A

smaller lesions are unlocular, bigger lesions can become multilocular with well defined boarders

46
Q

Ameloblastic Fibroma histo

A

Myxoid connective tissue that resembles dental papilla that contains strands and islands of odontogenic epithelium that resembles dental lamina

47
Q

Ameloblastic Fibroma, CT resembles what

A

dental papilla

48
Q

Ameloblastic Fibroma epithelial islands can resemble what?

A

ameloblastoma

49
Q

Ameloblastic Fibroma odontogenic epithelial resembles what

A

dental lamina

50
Q

Ameloblastic Fibroma trt

A

aggressive curettage

51
Q

Ameloblastic Fibroma prognosis

A

good

52
Q

Ameloblastic Fibroma recurrence rate

A

low

53
Q

Ameloblastic Fibro-Odontoma

A

Odontogenic tumor with features of ameloblastic fibroma as well as odontoma

54
Q

Ameloblastic Fibro-Odontoma who and when

A

children, 10 years old average age

55
Q

Ameloblastic Fibro-Odontoma where

A

Equal frequency in mandible and maxilla

56
Q

Ameloblastic Fibro-Odontoma clinically

A

Asymptomatic swelling with large lesions Failure of tooth eruption may be noted

57
Q

Ameloblastic Fibro-Odontoma radiographically

A

Well-circumscribed unilocular, or occasionally multilocular, radiolucency
Varying amounts of calcified material having the density of tooth structures

58
Q

Ameloblastic Fibro-Odontoma, often associated with what

A

impacted tooth

59
Q

Ameloblastic Fibro-Odontoma histo

A

Odontoma areas (usually complex odontoma) together with areas of ameloblastic fibroma. characteristics of both

60
Q

Ameloblastic Fibro-Odontoma trt

A

conservative curettage

61
Q

Ameloblastic Fibro-Odontoma prognosis

A

excellent

62
Q

Odontoma

A

probably not a true neoplasm but a odontogenic hamartoma.

63
Q

Odontoma, two forms

A

compound and complex

64
Q

Odontoma when

A

Most are detected during the first two decades of life, mean age of 14 years

65
Q

Odontoma where

A

Slightly more frequent in the maxilla compared to the mandible

66
Q

Odontoma associated with what

A

unerupted tooth

67
Q

compound odontomas seen mainly where

A

anterior maxilla

68
Q

complex odontomas seen mainly where

A

posterior portion or maxilla or mandible

69
Q

compound odontoma clinically

A

as a collection of small malformed teeth surrounded by a narrow radiolucent rim, often overlying an impacted tooth


70
Q

compound odontoma histopath

A

shows the formation of multiple small malformed teeth

71
Q

complex odontoma histopath

A

shows a mixture of dentin, enamel matrix, cementum, odontogenic epithelium and dental papilla

72
Q

odontoma trt and prognosis

A

enucleation

excellent

73
Q

Odontogenic Myxoma

A

Benign neoplasm assumed to be of odontogenic origin because the jaw bones are the only skeletal sites affected

74
Q

Odontogenic Myxoma when

A

Primarily affects young adults, but seen over a wide age range
Average is 25-30 years

75
Q

Odontogenic Myxoma where

A

Mandible affected slightly more than maxilla

76
Q

Odontogenic Myxoma, larger lesion present with what

A

asymptomatic expansion of bone

77
Q

Odontogenic Myxoma radiographically

A

Unilocular when small; multilocular when large

May have a “soap-bubble” appearance

78
Q

Odontogenic Myxoma histo

A

Spindle-shaped or stellate-shaped fibroblastic cells set in a myxoid background
The lesional proliferation tends to infiltrate the adjacent bony trabeculae

79
Q

Odontogenic Myxoma trt and prognosis

A

small lesions- curettage
large lesions en bloc segmental resection
prognosis- good

80
Q

Odontogenic Myxoma recurrence rates

A

up to 25%

81
Q

Cementoblastoma when

A

under 25 years old usually

82
Q

Cementoblastoma where

A

mandibular molar region

83
Q

Cementoblastoma growth

A

slow growing, may produce expansion or pain

84
Q

Cementoblastoma radiographically

A

Well-circumscribed radiopaque mass with a fine radiolucent border
Fused to the resorbed root of a tooth, usually a mandibular first molar

85
Q

Cementoblastoma usually fused to what

A

resorbed root of a tooth

86
Q

cementoblastoma look like if excised

A

Trabeculae of mineralized material that resembles cementum

The trabeculae are rimmed by plump, angular cells that represent neoplastic cementoblasts

87
Q

Cementoblastoma differential diagnosis

A

osteoblastoma, osteosarcoma

88
Q

Cementoblastoma trt

A

Surgical extraction of the involved tooth with enucleation of the lesion

Alternatively, the tooth can be endodontically treated followed by root amputation and removal of the lesion with the involved root

89
Q

Cementoblastoma prognosis

A

excellent

Oral Path 3 (3 decks)

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