Oral Facial & Bone Neoplasms Flashcards
What is neoplasia?
New growth
What is a neoplasm?
An abnormal growth that exceeds normal tissue
It is uncoordinated & persists after the cessation of the stimulus that caused it.
How do we differentiate neoplasia?
Into benign and malignant.
How do benign and malignant neoplasms look?
In benign neoplasms they are:
-well-differentiated, looks like tissue of origin with organised structure.
-the rate of growth is usually slow
-normally well-circumscribed with no invasion
-no metastasis
In malignant neoplasms they are:
-un-differentiated, looks different to the tissue of origin with a disorganised structure
-rate of division of cells is very high so it outstrips its blood supply.
This causes starvation of blood = Necrosis
-Invasive with poorly defined margin
-metastasis is common
What are some examples of benign oral neoplasia?
Haemangioma
Lipoma
Fibroepithelial polyp
Papilloma
Naevus
Pyogenic granuloma
Ameloblastoma
Pleomorphic adenoma
Bony exostosis
Most of these have the word ‘oma’ at the end. So ‘Oma’ usually indicates benign neoplasia
Haemangioma is a benign vasoformative neoplasm. What does this mean?
-It’s formed from either capillaries or blood vessels.
-So can either be described as a capillary or cavernous haemangioma
What is characteristic of a haemangioma?
Blanches on pressure
What can a haemangioma cause?
Troublesome bleeding or oral cosmetic defects e.g on the lip
How do you treat a haemangioma?
Cryotherapy/sclerotherapy (inject irritant into vascular space causing scaring) /excision.
What is a lipoma and where can it occur?
-It’s a benign neoplasm of adipose tissue
-can occur anywhere where there is subcutaneous/dermal fat (fatty tissue eg neck, oral cavity ,face.
What does a lipoma look like and how is it treated?
Soft yellow or pink with overlying mucosa/skin
Treat with surgical excision
What is a fibroepithelial polyp (FEP) and what does it look like?
It’s the most common benign epithelial tumour of the oral cavity (although uncommon before the age of 30)
& it’s a painless flat or pedunculate lesion
How can a FEP be caused and how do you treat it?
Inflammatory hyperplasia due to chronic irritation e.g. cheek biting
Treat by local surgical excision if troublesome
What is a papilloma?
-Benign proliferating lesion caused by human papilloma virus (HPV-not oral cancer)
-is most common between age 30 - 50
What is a papilloma caused by?
HPV strains 6 & 11, not the cancer inducing type 16 & 18
Where are papillomas most common and how do you treat them?
-Soft palate and tongue
-Local surgical excision or cryotherapy if troublesome
What is a melanocytic naevi and how is it causes also how do you treat it?
-Pigmented mole that develops in childhood & early adult life (30-40)
-Runs in families (sun exposure/sun burn)
-Remove by local surgical excision if troublesome or of concern
What is a pyogenic granuloma and what causes it?
-It’s a reactive hyperplasia of connective tissue (no pus & not a granuloma)
-Usually due to low grade irritation, trauma, poor oral hygiene, hormonal change (so it’s more common in females than in males)
Where are pyogenic granulomas most commonly found?
Gingiva, buccal mucosa, tongue & lips
How do you treat pyogenic granulomas?
Local surgical excision (including base) plus improved Oral hygien
What is an ameloblastoma and where does it commonly occur?
Benign tumour of odontogenic epithelium - usually found in x-rays
80% of these occur in the mandible, most commonly in the posterior region
What can ameloblastomas cause?
Expansion of the bone & resorption of adjacent tooth roots
Are ameloblastomas invasive?
Yes, they are actually locally invasive (very rarely metastatic spread to lung)
How do you treat ameloblastomas?
Surgical excision with margin/enucleation possible
Must be monitored - could re-occur
What are pleomorphic adenomas and what/who does it affect?
Most common salivary gland tumour (accounting for 80% of them)
Parotid gland more commonly affected
F>M 2:1
it can occur at any age but it’s most frequent in 30-60 year olds
How are pleomorphic adenomas treated?
Careful surgical excision required
Can get bigger overtime and risk of malignancy.
What is a bony exostosis/ torus and where is it most common?
Benign localised peripheral overgrowth of bone.
Most common in palate and lingual aspect of mandible.
Why are bony exostoses frequently traumatised?
Due to location & thin mucosa
How do you treat a bony exostosis/torus?
Surgical reduction if functionally/cosmetically problematic
