Oral Path: Odontogenic Cysts & Tumors Flashcards
Cysts
Cavities lined by epithelium
Odontogenic Cysts
derived from cells associated w/tooth formation
Radicular Cyst
Aka Periapical Cyst
Most common odontogenic cyst
Radiolucency at apex
* Always Nonvital tooth
Necrotic pulp –> periapical inflammation
* Acute=Abscess
* Chronic=Granuloma
Epithelial Rests of Malassez (ERM)
* from Hertwig’s Epithelial Root Sheath (HERS)
* encapsulate lesion=forms cyst
Tx: RCT, apicoectomy, or EXt w/curretage
Dentigerous Cyst
Aka Eruption Cyst
Accumulation of fluid b/w crown & Reduced Enamel Epithelium
Radiolucency attached to CEJ of impacted teeth
Most common: K9s & 3rd molars
Tx: Excision, but might be source of future odontogenic tumor
Lateral Periodontal Cyst
Most common=mandibular premolar region
* Always vital tooth
* not centered around apex
Gingival Cyst of Adult
Soft tissue part of Lateral Periodontal Cyst
NO Radiolucency bc not in bone
Gingival cyst of Newborn
Rests of dental lamina epithelialize the small lesions
Bohn’s Nodules=Lateral Palate
Epstein’s Pearls=midline palate
Tx: None,
* will go away as children get older
Primordial Cyst
Develops where a tooth would have formed, but didn’t
Most common area=Mandibular 3rd molar
Tx: Complete removal
Keratocystic Odontogenic Tumor (KCOT)
Aggressive & recurrent
Posterior Ascending Ramus of Mandible:
* Fusiform, M-D expansion (Not B-L)
* minimal displacement of teeth or resorption
Tx: Aggressive enucleation
Gorlin Syndrome
=Multiple KCOTs (Keratocystic odontogenic tumor)
+ Multiple BCCs (Basal Cell Carcinomas)
+ Calcified Falx Cerebri
+ Fatal Disease
Aka Nevoid Basal Cell Carcinoma
Calcifying Odontogenic Cyst
aka Gorlin Cyst
Rare & Unpredictable
Involves: Ghost Cells
* empty space and filled w/keratin–> Calcify
* Little radiodencities on x-ray
Ameloblastoma
Benign BUT very AGGRESSIVE
Posterior Mandible
* Multilocular expansive lesion (Beach Ball B-L Expansion) w/erosion and displacement of roots & cortical bone
Tx: Wide excision or resection
* if too conservative=high recurrence
Classic Differential Diagnosis for Multilocular Radiolucency in posterior mandible?
Ameloblastoma
KCOT (Keratocystic Odontogenic Tumor)
CGCG (Central Giant Cell Granuloma)
COF (Central Odontogenic Fibroma)
Calcifying epithelial Odontogenic Tumor (CEOT)
Aka Pindborg Tumor
Radiolucency with driven snow calcifications (White flecks)
Liesegang rings: amorphous pink amyloid w/concentric calcifications
Tx: Surgical Excision, good prognosis
Adenomatoid Odontogenic Tumor (AOT)
anterior maxilla over impacted canine (most common)
Contains:
* epithelial duct-like spaces
* enameloid material
Odontogenic Myxoma
aka Myxofibroma
Myxomatous CT=Slimy stroma
* Pulp-like material w/minimal collagen
Messy radiolucency with:
* unclear borders
* honeycomb/tennis racket pattern
Tx: Surgical Excision, moderate recurrence
Central Odontogenic Fibroma (COF)
Dense collagen w/strands of epithelium woven w/in it
Types:
Central:
* Bone
* well defined multilocular radiolucency
Peripheral:
* Gingiva
* No RL (not seen on x-ray)
Cementoblastoma
Well-circumscribed radiopaque mass
* ball of cementum + cementoblasts= replace root of tooth
Connected to the root (Surrounded by a PDL Space)
tx: Surgical excision and extraction
Ameloblastic Fibroma
Children & Teens
Posterior mandible
* contain: Myxomatous CT
Tx: Surgical Excision
Odontoma
Opaque lesion
* composed of dental hard tissues
* block eruption of teeth
2 types:
Compound:
* anterior
* “bag of teeth”
Complex:
* posteiror
* conglomerate mass of dental tissue
Gardner Syndrome
=Multiple Odontomas
+ Intestinal Polyps
Hodgkin’s Lymphoma
Oral cavity=rare
Reed-Sternberg cells= Malignant B cells
Tx: Chemo +/- radiation
Non-Hodgkin’s Lymphoma
Neoplasm of B or T cells
Burkett’s Lymphoma= Type of B cell NHL
Involves:
* bone marrow
* swelling
* pain
* tooth mobility
* Lip paresthesia (Pins & needs)
* Halted tooth development
Tx: Chemo +/- chemo
Multiple Myeloma
Aka Plasma Cell Myeloma
Neoplasm of Plasma Cells
* Antibody-secreting B cells
multiple punched out radiolucencies in skull
Amyloidosis
* Accumulation of amyloid proteins-from antibody light chains
Tx: Chemotherapy- Poor prognosis
Leukemia
Neoplasm of Bone Marrow cells:
* Lymphocytes
* NK Cells
* Granulocytes
* Megakaryocytes
Classification based on cell lineage (Myeloid or lymphoid) & Acute vs chronic:
* ALL -> CML -> AML -> CLL (Youngest to oldest)
* ALL Children Are Chill
Clinical Signs:
* Bleeding (Platelets)
* Fatigue (RBC)
* Infection (WBC)
Even though we are seeing increased production of bone marrow cells, they are immature & have less fxn
