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

Odontogenic Neoplasms - part II Flashcards

1
Q

tumors of mixed odontogenic epithelium/ectomesenchyme

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

T/F: epithelial and ectomesencymal cells in ameloblastic fibroma lesions are neoplastic

A

true

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3
Q

T/F: smaller ameoblastic fibroma lesions are asymptomatic

A

true

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4
Q

what does larger ameoblastic fibroma lesions produce?

A

painless expansion

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5
Q

where does ameoblastic fibroma most commonly occurs?

A

post mand

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6
Q

radiographic features of ameoblastic fibroma

A
  1. unilocular when small
  2. multilocular when large
  3. margins may be well-defined or sclerotic
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7
Q

histopathologic features of ameoblastic fibroma

A
  1. proliferating odontogenic epithelium in a cellular ectomesenchyme resembling dental papilla
  2. myxoid CT contains strands and islands of odontogenic epithelium resembling dental lamina
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8
Q

what does the myxoid CT in ameoblastic fibroma lesions look like histopathologically?

A

like a primitive dental pulp

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9
Q

what might ameoblastic fibroma resemble histopathologically?

A

ameloblastoma

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10
Q

tx for ameoblastic fibroma

A

aggressive curettage

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11
Q

px of ameoblastic fibroma

A

good

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12
Q

what is needed after tx’ing ameoblastic fibroma?

A

periodic radiographic f/u

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13
Q

T/F: ameoblastic fibroma has a rare malignant transformation

A

true

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14
Q

clinical features of ameloblastic fibro-odontoma

A

asymptomatic, although large lesions cause swelling

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15
Q

what might ameloblastic fibro-odontoma be associated with?

A

failure of tooth eruption

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16
Q

T/F: ameloblastic fibro-odontoma occurs more often in the mandible

A

false, equal frequency mand and max

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17
Q

what might ameloblastic fibro-odontoma be confused with?

A

developing odontoma

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18
Q

radiographic features of ameloblastic fibro-odontoma

A
  1. well-circumscribed unilocular radiolucency, but may be multilocular
  2. varying amounts of calcified material with density of tooth
  3. often overlies impacted tooth
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19
Q

histopathologic features of ameloblastic fibro-odontoma

A
  1. features of ameloblastic fibroma with an odontoma
  2. amount of each type of tissue varies
  3. areas of ameloblastic fibroma seen
  4. odontoma usually complex type
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20
Q

tx with ameloblastic fibro-odontoma

A

conservative excision

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21
Q

px of ameloblastic fibro-odontoma

A

excellent

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22
Q

T/F: recurrence of ameloblastic fibro-odontoma is common

A

false, unusual

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23
Q

what are the two forms of odontoma?

A
  1. compound

2. complex

24
Q

where is compound odontoma typically found?

A

anterior jaw

25
Q

where is complex odontoma typically found?

A

posterior jaw

26
Q

if odontoma is not a true neoplasm, what is it?

A

odontogenic hamartoma

27
Q

what might odontoma be associated with?

A

failure of tooth eruption

28
Q

T/F: odontoma occurs slightly more frequently in mandible than maxilla

A

false, more frequently in maxilla than mandible

29
Q

radiographic features of compound odontoma

A
  1. collection of small malformed teeth surrounded by narrow radiolucent rim
  2. often overlies impacted tooth
30
Q

radiographic features of complex odontoma

A
  1. calcified mass, if fully formed has density of tooth structure
  2. surrounded by narrow radiolucent rim
  3. typically overlies impacted tooth
31
Q

histopathologic features of compound odontoma

A

formation of multiple, small malformed teeth

32
Q

histopathologic features of complex odontoma

A

admixture of

  1. dentin
  2. enamel matrix
  3. cementum
  4. odontogenic epithelium
  5. dental papilla
33
Q

tx of odontoma

A

enucleation

34
Q

px of odontoma

A

excellent

35
Q

tumors of odontogenic ectomesenchyme

A
  1. odontogenic myxoma

2. cementoblastoma

36
Q

odontogenic myxoma

A

benign neoplasm assumed to be of odontogenic origin

37
Q

why is odontogenic myxoma assumed to be of odontogenic origin?

A

b/c it only affects the jaw bones as a central lesion - no other bones

38
Q

T/F: odontogenic myxoma affects mandible slightly more often than maxilla

A

true

39
Q

what might larger odontogenic myxoma lesions have?

A

expansion

40
Q

radiographic features of odontogenic myxoma

A
  1. unilocular radiolucency when small
  2. multilocular when large
  3. may have “soap bubble” appearance
  4. may displace roots
  5. may cause root resorption
  6. thin, wispy trabeculae of residual bone, often at right angles
41
Q

histopathologic features of odontogenic myxoma

A
  1. spindle-shaped or stellate-shaped fibroblastic cells set in a myxoid background
  2. lesional proliferation tens to infiltrate adjacent bony trabeculae (recurrence)
42
Q

odontogenic myxoma histopathologically looks similar to what?

A

mesenchymal portion of a developing tooth (dental papilla)

43
Q

tx of small odontogenic myxoma lesions

A

curettage

44
Q

tx of large odontogenic myxoma lesions

A

en block or segmental resection, depending on the size and site

45
Q

px of odontogenic myxoma

A

good

46
Q

what contributes to the recurrence rate of odontogenic myxoma?

A

infiltration esp if only tx’d with curettage

47
Q

where does cementoblastoma appear most often?

A

most mand molar region, usually 1st molar

48
Q

what is the gender predilection for cementoblastoma?

A

no gender predilection

49
Q

clinical features of cementoblastoma

A
  1. slow-growing

2. pain and swelling

50
Q

radiographic features of cementoblastoma

A
  1. well-circumscribed radiopaque mass with fine radiolucent border (PDL)
  2. usually obscures the outline of root
  3. can cause resorption
51
Q

what is the distinguishing feature of cementoblastoma histopathologically?

A

fused to root

52
Q

the trabeculae of mineralize material in a cementoblastoma lesion seen histopathologically resembles what?

A

cementum

53
Q

histopathologic features of cementoblastoma

A
  1. fused to root

2. trabeculae are rimmed by plump, angular cells

54
Q

what does the angular cells found in cementoblastoma lesions histopathologically represent?

A

neoplastic cementoblasts

55
Q

differential dx of cementoblastoma

A
  1. osteoblastoma

2. osteosarcoma

56
Q

tx of cementoblastoma

A
  1. surgical extraction of involved tooth with enucleation of the lesion
  2. alternatively, tooth can be endo tx’d and lesion enucleated along with amputation of the involved root
57
Q

px of cementoblastoma

A

excellent

AU'18 Oral Path II (31 decks)

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