Odontogenic Neoplasms Flashcards
3 Tumors of odontogenic epithelium
- Ameloblastoma
- Adenoid Odontogenic Tumor (AOT)
- Calcifying Epithelial Odontogenic Tumor (CEOT)
3 Mixed tumors of odontogenic epithelium and odontogenic ectomesenchyme
- Ameloblastic fibroma
- Ameloblastic fibro-odontoma
- Odontoma
2 Tumors of odontogenic mesenchyme
- Odontogenic myxoma
2. Cementoblastoma
The frequency of this tumor is equal to the combined frequency of all other odontogenic tumors
Ameloblastoma
What feature of an ameloblastoma can be dramatic?
Expansion
Most common area for ameloblastoma?
Posterior mandible (molar/ramus region)
What is the radiographic appearance of ameloblastoma?
“Soap bubble or honeycomb”
Do the lesional cells of an ameloblastoma make enamel?
No
2 Most common histological patterns of ameloblastoma?
- Follicular
2. Plexiform
What do you see in the histology of an ameloblastoma?
Tumor islands
What type of cells are at the periphery of tumor islands in an ameloblastoma? Are the nuclei polarized toward or away from the basement membrane?
Cuboidal or columnar cells
Away from
Ameloblastoma insinuates through _____. This is the reason for an ___ ___ ____
Trabeculae
En bloc resection
Why do maxillary ameloblastomas have to be treated more aggressively?
Because of anatomic location (vital structures)
Prognosis for ameloblastoma?
Guarded
When is an ameloblastoma more likely to be fatal?
When it is in the maxilla
What is the soft tissue variant of an ameloblastoma?
Peripheral ameloblastoma
What is the histological difference between an ameloblastoma and a peripheral ameloblastoma?
The peripheral is located under the surface epithelium
Treatment for a peripheral ameloblastoma
The biopsy is often curative
Are most patients with Adenomatoid Odontogenic Tumor (AOT) old or young?
Young
AOTs have a ____ predilection, are mostly in the ____ (anterior/posterior) ______ (maxilla/mandible), and are often associated with ____
Female
Anterior
Maxilla
Impacted teeth
AOTs often cause _____ of roots
Divergence
An AOT has a well defined ____
Capsule
Which stratum layer will you find a Calcifying Epithelial Odontogenic Tumor (CEOT) in?
Stratum intermedium
CEOTs are often in the ____ (anterior/posterior) _____ (maxilla/mandible)
Posterior mandible
Radiographically, a CEOT is often ________ when small and _____ when large
Well-circumscribed
Multilocular
What type of radiographic pattern is seen with a CEOT?
“Driven snow”
The calcifications associated with a CEOT are called ___ ___
Liesegang rings (lamellated)
Is radical surgery warranted for a CEOT?
No
When the epithelial and ectomesenchymal cells are both neoplastic
Ameloblastic fibroma
Ameloblastic fibromas are typically seen in _____ (older/younger) patients, and are often seen in the _____ (anterior/posterior) ____ (maxilla/mandible)
Younger
Posterior mandible
The epithelial proliferation of ameloblastic fibromas resembles ____ ____
Dental papilla
The myxoid connective tissue of an ameloblastic fibroma contains strands and islands of odontogenic epithelium resembling ___ ____
Dental lamina
An ameloblastic fibro-odontoma is often seen in ____ (older/younger) patients. Where is it often seen?
Younger
Equal frequency in the mandible and maxilla
An ameloblastic fibro-odontoma often overlies a(n) ____ ____
Impacted tooth
The histology of an ameloblastic fibro-odontoma is the same as:
An ameloblastic fibroma with an odontoma
What type of odontoma is usually associated with an ameloblastic fibro-odontoma?
The complex type
2 forms of an odontoma and where they’re located
- Compound (usually anterior)
2. Complex (usually posterior)
An odontoma is probably a(n) ____ ____ rather than a true neoplasm
Odontogenic hamartoma
Odontomas are typically seen in ____ (older/younger) patients and are slightly more frequent in the _____ (maxilla/mandible)
Younger
Maxilla
Radiographically, a compound odontoma is a collection of
Small malformed teeth surrounded by a radiolucent rim
Radiographically, a complex odontoma is:
A calcified mass with the same density of tooth structure (if it is fully formed)
Histologically, what is seen in a complex odontoma?
A mix of dentin, enamel matrix, cementum, odontogenic epithelium and dental papilla
Benign neoplasm assumed to be of odontogenic origin because it only affects the jaw bones as a central lesion - no other bones
Odontogenic myxoma
Odontogenic myxomas are slightly more common in the ____ (maxilla/mandible)
Mandible
Odontogenic myxomas have a ____ ____ appearance
Soap bubble
What is unique about odontogenic myxomas on a radiograph?
There are thin, wispy trabeculae of residual bone, often at right angles
Treatment for an odontogenic myxoma if it is small? If it is large?
Small - curettage
Large - en bloc or segmental resection
What contributes to the recurrence rate of an odontogenic myxoma?
Infiltration
Cementoblastomas are usually seen in the _______ region
Mandibular molar (usually 1st molar)
Cementoblastomas are often associated with ___ and ___
Pain and swelling
Cementoblastomas often obscur the _______
Outline of the root
What is a distinguishing histological feature of a cementoblastoma?
It is fused to the root
Treatment for cementoblastoma
Surgically extract the involved tooth and enucleate the lesion (or endo, enucleation, and root amputation)
