Oral, facial and bone neoplasms Flashcards
What does neoplasia mean?
New growth
What is the definition of neoplasm?
It is an abnormal growth that exceeds normal tissue. It is uncoordinated and persists after the cessation of the stimulus that caused it
What 4 characteristics may you consider when assessing a neoplasm?
Differentiation
Rate of growth
Local invasion
Metastasis
What characteristics may indicate that a neoplasm is benign?
Well differentiated (looks like tissue of origin with organised structure)
Usually slow rate of growth
Normally well circumscribed with no invasion
Absent metastasis
What characteristics may indicate that a neoplasm is malignant?
Un-differentiated (looks different to tissue of origin with disorganised structure)
Likely to have rapid growth
Invasive with poorly defined margin
Commonly metastases
Name 3 benign oral neoplasia
- Haemangioma (small collection of blood vessels under mucosa)
- Lipoma
- Fibroepithelial polyp
- Papilloma
- Naevus
- Pyogenic granuloma
- Ameloblastoma
- Pleomorphic adenoma
- Bony exostosis
Describe a haemangioma (4)
Benign vasoformative neoplasm
Capillary or cavernous
Blanches on pressure
May cause troublesome bleeding or cosmetic detect
How do you treat a haemangioma? (3)
Cryotherapy
Sclerotherapy (inject solution into vessels, causing it to scar and forces blood to reroute and go to other vessels)
Excision
What is a lipoma?
Benign neoplasm of adipose tissue
Where can a lipoma occur?
Anywhere there is subcutaneous/dermal fat
What does a lipoma look like?
Soft yellow or pink with normal overlying mucosa/skin
How would you treat a lipoma?
Surgical excision
What is the most common benign epithelial tumour of the oral cavity?
Fibroepithelial Polyp (FEP)
What is a fibroepithelial polyp?
It is a painless flat or pedunculate (has stalk or stem) lesion. It is inflammatory hyperplasia due to chronic irritation (e.g. cheek biting).
It is uncommon before the age of 30
How would you treat a fibroepithelial polyp?
Local surgical excision if troublesome
What is a papilloma?
Between what ages is it most common?
Benign proliferating lesion caused by human papilloma virus.
30-50.
Where do papillomas most commonly occur?
Soft palate and tongue
What HPV causes papilloma?
HPV 6 and 11
How would you treat a papilloma? (2)
Local surgical excision or cryotherapy (if troublesome)
What is a melanocytic naevi?
It is a pigmented mole, which often runs in families
When are melanocytic naevi most likely to develop?
In childhood and early adult life (30-40)
How may you treat a melanocytic naevi?
Local surgical excision (if it is a concern or troublesome)
What is a pyogenic granuloma?
Reactive hyperplasia of connective tissue (no pus and not a granuloma) - they appear as small, raised red bumps that bleed easily due to high number of blood vessels
Are pyogenic granulomas more common in men or women?
Women
Where are pyogenic granulomas most likely to occur? (4)
Gingiva
Buccal mucosa
Tongue
Lips
What may cause a pyogenic granuloma? (4)
Low grade irritation
Trauma
Poor OH
Hormonal change
How would you treat a pyogenic granuloma?
Local surgical excision plus improved OH
What is an ameloblastoma?
Benign tumour of odontogenic epithelium
Where would you find the majority of ameloblastoma?
80% in the mandible (most commonly posterior region)
Describe the characteristics of ameloblastoma
Expansion, resorption of adjacent tooth roots.
Locally invasive (very rarely can metastatically spread to lung)
How would you treat ameloblastoma?
Surgical excision with margin/enucleation possible
What is the most common salivary gland tumour?
Pleomorphic adenoma (80%)
What gland is most commonly affected by pleomorphic adenoma?
Parotid gland
In what ratio does pleomorphic adenoma affect females and males? F:M
2:1
F:M
Pleomorphic adenoma can occur at any age, but between what ages is it most frequent?
30-60 years
How would you treat a pleomorphic adenoma?
Careful surgical excision
What is bony exostosis/torus?
Benign localised peripheral overgrowth of bone
Where are bony exostosis/torus most commonly found?
Palate and lingual aspect of mandible
Why may a patient may want to remove or reduce their bony exostosis/torus?
How would this be treated?
Because they can be frequently traumatised due to location and thin mucosa.
Can be surgically reduced if functionally/cosmetically problematic
If you are doubtful about a benign neoplasm in the oral cavity, what would you do?
Regularly review, take photos and x-rays
Refer if concerned of potential malignancy
