Odontogenic Neoplasms - part II Flashcards
tumors of mixed odontogenic epithelium/ectomesenchyme
- ameoblastic fibroma
- ameloblastic fibro-odontoma
- odontoma
T/F: epithelial and ectomesencymal cells in ameloblastic fibroma lesions are neoplastic
true
T/F: smaller ameoblastic fibroma lesions are asymptomatic
true
what does larger ameoblastic fibroma lesions produce?
painless expansion
where does ameoblastic fibroma most commonly occurs?
post mand
radiographic features of ameoblastic fibroma
- unilocular when small
- multilocular when large
- margins may be well-defined or sclerotic
histopathologic features of ameoblastic fibroma
- proliferating odontogenic epithelium in a cellular ectomesenchyme resembling dental papilla
- myxoid CT contains strands and islands of odontogenic epithelium resembling dental lamina
what does the myxoid CT in ameoblastic fibroma lesions look like histopathologically?
like a primitive dental pulp
what might ameoblastic fibroma resemble histopathologically?
ameloblastoma
tx for ameoblastic fibroma
aggressive curettage
px of ameoblastic fibroma
good
what is needed after tx’ing ameoblastic fibroma?
periodic radiographic f/u
T/F: ameoblastic fibroma has a rare malignant transformation
true
clinical features of ameloblastic fibro-odontoma
asymptomatic, although large lesions cause swelling
what might ameloblastic fibro-odontoma be associated with?
failure of tooth eruption
T/F: ameloblastic fibro-odontoma occurs more often in the mandible
false, equal frequency mand and max
what might ameloblastic fibro-odontoma be confused with?
developing odontoma
radiographic features of ameloblastic fibro-odontoma
- well-circumscribed unilocular radiolucency, but may be multilocular
- varying amounts of calcified material with density of tooth
- often overlies impacted tooth
histopathologic features of ameloblastic fibro-odontoma
- features of ameloblastic fibroma with an odontoma
- amount of each type of tissue varies
- areas of ameloblastic fibroma seen
- odontoma usually complex type
tx with ameloblastic fibro-odontoma
conservative excision
px of ameloblastic fibro-odontoma
excellent
T/F: recurrence of ameloblastic fibro-odontoma is common
false, unusual
what are the two forms of odontoma?
- compound
2. complex
where is compound odontoma typically found?
anterior jaw
where is complex odontoma typically found?
posterior jaw
if odontoma is not a true neoplasm, what is it?
odontogenic hamartoma
what might odontoma be associated with?
failure of tooth eruption
T/F: odontoma occurs slightly more frequently in mandible than maxilla
false, more frequently in maxilla than mandible
radiographic features of compound odontoma
- collection of small malformed teeth surrounded by narrow radiolucent rim
- often overlies impacted tooth
radiographic features of complex odontoma
- calcified mass, if fully formed has density of tooth structure
- surrounded by narrow radiolucent rim
- typically overlies impacted tooth
histopathologic features of compound odontoma
formation of multiple, small malformed teeth
histopathologic features of complex odontoma
admixture of
- dentin
- enamel matrix
- cementum
- odontogenic epithelium
- dental papilla
tx of odontoma
enucleation
px of odontoma
excellent
tumors of odontogenic ectomesenchyme
- odontogenic myxoma
2. cementoblastoma
odontogenic myxoma
benign neoplasm assumed to be of odontogenic origin
why is odontogenic myxoma assumed to be of odontogenic origin?
b/c it only affects the jaw bones as a central lesion - no other bones
T/F: odontogenic myxoma affects mandible slightly more often than maxilla
true
what might larger odontogenic myxoma lesions have?
expansion
radiographic features of odontogenic myxoma
- unilocular radiolucency when small
- multilocular when large
- may have “soap bubble” appearance
- may displace roots
- may cause root resorption
- thin, wispy trabeculae of residual bone, often at right angles
histopathologic features of odontogenic myxoma
- spindle-shaped or stellate-shaped fibroblastic cells set in a myxoid background
- lesional proliferation tens to infiltrate adjacent bony trabeculae (recurrence)
odontogenic myxoma histopathologically looks similar to what?
mesenchymal portion of a developing tooth (dental papilla)
tx of small odontogenic myxoma lesions
curettage
tx of large odontogenic myxoma lesions
en block or segmental resection, depending on the size and site
px of odontogenic myxoma
good
what contributes to the recurrence rate of odontogenic myxoma?
infiltration esp if only tx’d with curettage
where does cementoblastoma appear most often?
most mand molar region, usually 1st molar
what is the gender predilection for cementoblastoma?
no gender predilection
clinical features of cementoblastoma
- slow-growing
2. pain and swelling
radiographic features of cementoblastoma
- well-circumscribed radiopaque mass with fine radiolucent border (PDL)
- usually obscures the outline of root
- can cause resorption
what is the distinguishing feature of cementoblastoma histopathologically?
fused to root
the trabeculae of mineralize material in a cementoblastoma lesion seen histopathologically resembles what?
cementum
histopathologic features of cementoblastoma
- fused to root
2. trabeculae are rimmed by plump, angular cells
what does the angular cells found in cementoblastoma lesions histopathologically represent?
neoplastic cementoblasts
differential dx of cementoblastoma
- osteoblastoma
2. osteosarcoma
tx of cementoblastoma
- surgical extraction of involved tooth with enucleation of the lesion
- alternatively, tooth can be endo tx’d and lesion enucleated along with amputation of the involved root
px of cementoblastoma
excellent
