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AU'18 Oral Path II > Odontogenic Neoplasms - part I > Flashcards

Odontogenic Neoplasms - part I Flashcards

1
Q

odontogenic neoplasms

A
  1. tumors of odontogenic epithelium
  2. mixed tumors of odontogenic epithelium and odontogenic ectomesenchyme
  3. tumors of odontogenic ectomesenchyme
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2
Q

tumors of odontogenic epithelium

A
  1. ameloblastoma
  2. adenoid odontogenic tumor (AOT)
  3. calcifying epithelial odontogenic tumor (CEOT, Pindborg tumor)
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3
Q

mixed tumors of odontogenic epithelium and odontogenic ectomesenchyme

A
  1. ameloblastic fibroma
  2. ameloblastic fibro-odontoma
  3. odontoma
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4
Q

tumors of odontogenic ectomesenchyme

A
  1. odontogenic myxoma

2. cementoblastoma

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5
Q

T/F: ameloblastoma is benign but locally aggressive

A

true

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6
Q

clinical features of ameloblastoma

A
  1. painless

2. slow growing

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7
Q

T/F: the frequency of ameloblastoma equals combined frequency of all other odontogenic tumors

A

true

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8
Q

what gender predilection does ameloblastoma have?

A

no gender predilection

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9
Q

T/F: ameloblastoma usually expands rather than perforates bone

A

true

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10
Q

T/F: expansion from ameloblastoma can be dramatic

A

true

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11
Q

list the order of sites from most to least affected by ameloblastoma

A
  1. post mand (66%)
  2. mand PM region (11%)
  3. anterior mand (10%)
  4. anterior and posterior max (6%)
  5. max PM region (1%)
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12
Q

where does most ameloblastoma appear radiographically?

A

most in molar/ramus region of mand, but can occur anywhere

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13
Q

radiographic features of ameloblastoma

A
  1. unilocular/multilocular with well-defined but not sclerotic borders esp small lesions
  2. may displace teeth/resorb roots
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14
Q

what does multilocular expansile radiolucency due to ameloblastoma look like radiographically?

A

“soap bubble” or “honeycomb”

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15
Q

histopathologic features of ameloblastoma

A
  1. no enamel produced by lesional cells
  2. several different patterns
  3. tumor often infiltrates bony trabeculae (recurrence)
  4. tumor islands showing cuboidal or columnar cells at periphery
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16
Q

what does ameloblastoma resemble histopathologically?

A

ameloblasts of the enamel organ

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17
Q

what are the 2 most common patterns seen of ameloblastoma microscopically?

A
  1. follicular

2. plexiform

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18
Q

what is the center of tumor islands in ameloblastoma seen histopathologically composed of?

A

loosely arranged polyhedral epithelial cells that resemble stellate reticulum

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19
Q

what are the cubodial or columnar cells at the periphery seen histopathologically of ameloblastoma?

A
  1. ameloblast-like cells with reverse polarization

2. nuclei are polarized AWAY from the basement membrane

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20
Q

follicular pattern of ameloblastoma seen histopathologically

A
  1. islands with hyperchromatic, palisaded basal cells showing reverse polarization
  2. central zones resemble stellate reticulum
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21
Q

plexiform patter of ameloblastoma seen histopathologically

A

anastomosing cords of odontogenic epithelium

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22
Q

T/F: unicystic cysts can only be seen microscopically

A

true

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23
Q

what is the reason for en bloc resection of ameloblastoma?

A

insinuates through trabeculae

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24
Q

tx of ameloblastoma depends on what?

A
  1. size

2. site

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25
Q

tx of small ameloblastoma

A

aggressive curettage or small en bloc resection

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26
Q

tx of large ameloblastoma

A

large en bloc resection or segmental resection with reconstruction

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27
Q

why are maxillary ameloblastoma lesions tx’d more aggressively?

A

due to anatomic location (vital structures)

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28
Q

px of ameloblastoma

A

guarded

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29
Q

T/F: there is a higher recurrence of ameloblastoma if tx is simple curettage

A

true

30
Q

T/F: ameloblastoma cannot be fatal

A

false, can be esp max lesions

31
Q

T/F: it;s common for ameloblastoma to transform

A

false, rare

32
Q

how many years after tx

ing ameloblastoma should a radiogrpahic follow-up be done for?

A

annual radiographic f/u for 8-10 yrs

33
Q

periapical ameloblastoma

A

soft tissue variant of ameloblastoma

34
Q

clinical features of periapical ameloblastoma

A
  1. gingival mass

2. less than 2 cm

35
Q

what can periapical ameloblastoma look like clinically?

A

gingival bumps

36
Q

T/F: peripheral ameloblastoma is symptomatic

A

false, asymptomatic

37
Q

where does peripheral ameloblastoma usually affect?

A

mand, post

38
Q

who is affected by peripheral ameloblastoma?

A

middle-aged adult

39
Q

radiographic features of peripheral ameloblastoma

A

no radiographic findings…

no, or limited bone involvement (may have superficial erosion)

40
Q

peripheral ameloblastoma is histopathologically similar to conventional ameloblastoma except what?

A

lesion is located under the surface epithelium

41
Q

tx of peripheral ameloblastoma

A

biopsy is often curative if innocuous lesion

42
Q

T/F: pts with AOT often have no change to their alveolar bone

A

true

43
Q

clinical features of AOT

A
  1. can have expansion/swelling

2. asymptomatic

44
Q

T/F: peripheral AOT (soft tissue) is common

A

false, rare

45
Q

what is the gender predilection for AOT?

A

2:1 female predilection

46
Q

what is the location predilection for AOT?

A

2:1 maxillary predilection

47
Q

the most common site for AOT

A

anterior jaws

48
Q

majority of AOT cases are associated with what?

A

impacted tooth

49
Q

list the order from most to least common sites for AOT

A
  1. anterior max (53%)
  2. anterior mand (27%)
  3. max PM region (9%)
  4. mand PM region (7%)
  5. post max and mand (2%)
50
Q

T/F: AOT is often an incidental finding on radiographs

A

true

51
Q

radiographic features of AOT

A
  1. well-circumscribed unilocular radiolucency
  2. ± radiopaque flecks
  3. often causes divergence of adjacent roots
  4. pericoronal lucency may extend apically beyond CEJ
52
Q

histopathologic features of AOT

A
  1. well-developed capsule
  2. swirling spindle-cell nests and duct-like structures “adenomatoid”
  3. foci basophilic calcified material may be seen
53
Q

tx of AOT

A

enucleation

54
Q

prognosis of AOT

A

excellent

55
Q

T/F: recurrence of AOT is common

A

false, rare

56
Q

what is calcifying epithelial odontogenic tumor (CEOT) also known as?

A

Pindborg tumor

57
Q

before CEOT was described by Pindborg in 1956, what was it probably confused with?

A

ameloblastoma

58
Q

histogenesis of CEOT presumes what?

A

stratum intermedium

59
Q

Is CEOT common?

A

no, rare

60
Q

what is the gender predilection for CEOT?

A

no gender predilection

61
Q

what is the location predilection for CEOT?

A

2:1 mand, usually posterior

62
Q

clinical features of CEOT

A
  1. may have expansion

2. asymptomatic

63
Q

what is CEOT associated with?

A

impacted tooth

64
Q

list the order from most to least common sites for CEOT

A

post mand (57%) > post max (21%) > anterior mand (14%) > anterior max (8%)

65
Q

radiographic features of CEOT

A
  1. well-circumscribed radiolucency when small, multilocular when enlarges
  2. margins well-defined but may be ill-defined
  3. ± radiopaque flecks
66
Q

what is the pattern of the radiopaque flecks seen with CEOT?

A

“driven snow” pattern

67
Q

histopathologic features of CEOT

A
  1. proliferation of polyhedral epithelial cells with eosinophilic cystomplasm
  2. nuclei frequently pleomorphic
  3. rare mitoses
  4. calcifications
68
Q

the epithelial cells seen with CEOT histopathologically is associated with what?

A

amyloid (eosinophilic, homogenous)

69
Q

what are the calcifications of CEOT seen histopathologically called?

A

Liesegang rings (lamellated)

70
Q

tx of CEOT

A
  1. conservative excision

2. periodic radiographic follow-up

71
Q

T/F: radical surgery is warrented in tx’ing CEOT

A

false, is not

72
Q

px of CEOT

A

good

AU'18 Oral Path II (31 decks)

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