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Oral Path Exam 3 > Odontogenic Neoplasms > Flashcards

Odontogenic Neoplasms Flashcards

1
Q

3 tumors of Odontogenic Epithelium

A

1) Amolblastoma
2) Adenomatoid Odontogenic Tumor
3) Calcifying Epithelial Odontogenic tumor (CEOT)

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2
Q

3 mixed odontogenic tumors

A

1) Ameloblastic Fibroma
2) Ameloblastic Fibro-odontoma
3) Odontoma

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3
Q

2 tumors of odontogenic Ectomesenchyme

A

1) Odontogenic Myxoma

2) Cementoblastoma

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4
Q

Benign, but locally aggressive neoplasm of odontogenic epithelial origin that resembles the ameloblasts of the enamel organ, except no enamel is being produced

A

Ameloblastoma

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5
Q

What is the most common odontogenic tumor

A

Ameloblastoma, more common than all other combined

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6
Q

Percent of oral pathology accession Ameloblastoma accounts for, sex predilection, average age

A
  • 0.2% of oral pathologies
  • No sex
  • 33 years old
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7
Q

Area Ameloblastoma are most common and percent associated w/ impacted teeth

A
  • Molar-ramus area of the mandible

- 20% associated w/ impacted teeth

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8
Q

Signs and symptoms of an Ameloblastoma

A
  • Slow growth, destroying tissue and expanding (not perforating) bone, usually asymptomatic except for swelling
  • May displace or resorb roots
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9
Q

Radiographic appearance of Ameloblastoma (small and large)

A
  • Small- Unilocular radiolucency w/ well defined borders

- Large- Multilocular soap bubble appearance

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10
Q

Typically plexiform and follicular pattern w/ single layer of columnar ameloblast like cells at periphery w/ nuclei polarized away from BM and tumor islands composed of polyhedral epithelial cells that resemble stellate reticulum

A

Ameloblastoma

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11
Q

Treatment and prognosis for Ameloblastoma, which arch should they be treated more aggressively

A
  • Small- Aggressive curretage or small en bloc resection
  • Large- En bloc or segemental resection and reconstruction
  • Maxillary
  • Guarded (55-90% recur w/ curretage, 15% recur w/ marginal resection)
  • Can be fatal, rare malignant transformation, follow up for 8-10 years
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12
Q

Asymptomatic gingival mass w/ no or minimal bone involvement

A

Peripheral Ameloblastoma

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13
Q

Age Peripheral Ameloblastoma is seen

A

Middle aged adult

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14
Q

Clinical presentation and treatment of Peripheral Ameloblastoma

A

Many gingival bumps (<2 cm), biopsy is currative

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15
Q

Asymptomatic swelling of enamel organ or dental lamina rests often discovered incidentally

A

Adenomatoid Odontogenic Tumor

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16
Q

Age, sex, and location (%s) Adenomatoid Odontogenic Tumor are sen

A
  • Most under 20
  • 2:1 F, 2:1 max
  • 75% in ant jaw
  • 75% w/ impacted tooth
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17
Q

Radiographic appearace of Adenomatoid Odontogenic Tumor

A

Well circumscribed unilocular radiolucency, pericoronal radiolucency may extend apically beyond DEJ
- Seperation of roots and displacement of teeth

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18
Q

Tumor cells forming swirling spindle cell nests and duct like structures (adenomatoid), foci of basophilic material

A

Adenomatoid Odontogenic Tumor

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19
Q

Treatment and Prognosis of Adenomatoid Odontogenic Tumor

A
  • Enucleation and excellent
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20
Q

Rare odontogenic epithelial neoplasm that is thought to be from stratum intdermedium

A

CEOT (Pindborg Tumor)

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21
Q

Age and location common w/ CEOT

A
  • 40

- 2:1 mandible (esepecially posterior)

22
Q

What are the symptoms and what is a CEOT usually associated with

A
  • Swelling

- Usually impacted tooth

23
Q

Radiographic findings of CEOT

A
  • Small- well circumsribed radiolucenct

- Can become multilocular w/ radiopaque flecks

24
Q

Tumor w/ proliferation of polyhedral epithelial cells w/ eosinphilic cytoplasm w/ pleomorphic nuclei

25
Q

Structures in CEOT where epithelial cells stain eosinophilic and homogenous material stains amyloid where calcifications develop and form lamellated structures

A

Liesegang rings

26
Q

Treatment and prognosis of CEOT

A
  • Conservative excision

- Recurs 15%

27
Q

Mixed odontogenic tumor w/ proliferationg odontogenic epithelium in a cellular ectomesenchyme resemling the dental papilla

A

Ameloblastic Fibroma

28
Q

Age and location common w/ Ameloblastic Fibroma

A

Younger patients, 70% in posterior mandible

29
Q

Symptoms/radiographs of small/large Ameloblastic Fibroma

A
  • Small- Asymptomatic and uni
  • Large- Painless swelling, multi
  • Margins are sclerotic or well defined
30
Q

Tumor w/ myxoid CT resembling dental papilla w/ strands of odontogenic epithelium resembling the dental lamina (can vaguely resemble ameloblastoma)

A

Ameloblastic Fibroma

31
Q

Treatment and prognosis for Ameloblastic Fibroma

A
  • Aggressive curettage

- Good, 15% recur, low transformation

32
Q

Odontogenic tumor w/ features of ameloblastic fibroma admixed w/ and odontoma

A

Ameloblastic Fibro-Odontoma

33
Q

Age and symptoms w/ Ameloblastic Fibro-Odontoma

A
  • 10 years

- Asymptomatic unless failure of tooth eruption or swelling

34
Q

Location of Ameloblastic Fibro-Odontoma

A
  • Equal max and mand

- Radiolucency w/ calcified material overlying and impacted tooth

35
Q

What type of odontoma is the odontoma portion of a Ameloblastic Fibro-Odontoma

36
Q

Treatment and prognosis for Ameloblastic Fibro-Odontoma

A
  • Curretage

- Excellent

37
Q

Probably not a true neoplasm but an odontogenic hamartoma

38
Q

What are the 2 forms of Odontomas and where are they located

A

1) Compound (anterior jaw)

2) Complex (posterior jaw)

39
Q

Age, associated, and location of Odontomas

A
  • 14 years old
  • Usually w/ unerupted tooth
  • Max a little more than mand
40
Q

How does a compound Odontoma present

A
  • Collection of small malformed teeth surrounded by radiolucent rim overlying an impacted tooth
41
Q

How does a complex Odontoma present

A
  • Calcified mass that can have density of tooth, surrounded by radiolucent rim overlying and impacted tooth (shows mix of dentin, emamel, cementum, odontogenic epithelium and dental papilla)
42
Q

Treatment and prognosis for Odontoma

A
  • Enucleation, excellent
43
Q

Benign neoplasm of odontogenic origin because it only affects the jaw as a central lesion

A

Odontogenic Myxoma

44
Q

Age, location, and symptoms of Odontogenic Myxoma

A
  • Younger adults (25-30)
  • Mandible slightly more than max
  • Larger lesions expansion of bone
45
Q

Radiographic Odontogenic Myxoma

A
  • Uni then multilocular, soap bubbl
  • Can displace teeth/roots
  • Thin, wispy trabecuclae of residual bone often at right angles
46
Q

Tumor that has spindle or stellate shaped fibroblastic cells in a myxoid background, infiltrates adjacent bony trabeculae

A

Odontogenic Myxoma

47
Q

Treatment and prognosis of Odontogenic Myxoma

A
  • Small- curretage
  • Large- en bloc or segemental resecetion
  • Good, 25% recur
48
Q

Well-cirumscribed radiopaque mass w/ a radiolucent border that fuses to the resorbed root of a mandibular first molar

A

Cementoblastoma

49
Q

Age, location, and signs/symptoms of Cementoblastoma

A
  • Patients under 25
  • Mand molar
  • Slow growing, and pain and swelling seen 67% of tme
50
Q

Has trabeculae of mineralized material that resembles cementum and are rimmed by plump angular cells that represent neoplastic cementoblasts

A

Cementoblastoma

51
Q

Differential diagnosis for Cementoblastoma and distinguishing feautre

A

Osteoblastoma/sarcoma

- Fusion to root is distinguishing feature

52
Q

Treatment and prognosis for Cementoblastoma

A
  • Extraction of tooth and enucleation
  • RCT, enucleation and amputation of involed root
  • Excellent prognosis

Oral Path Exam 3 (4 decks)

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