ORAL PATH odontogenic tumours

Question 1

name types of benign mixed epithelial and mesenchymal odontogenic tumours?

Answer 1

odontoma
primordial odontogenic tumour
ameloblastic fibroma
dentinogenic ghost cell tumour

Question 2

list types of benign mesenchymal odontogenic tumours?

Answer 2

odontogenic fibroma
cementoblastoma
cemento-ossifying fibroma
odontogenic myxoma

Question 3

list types of malignant odontogenic tumours?

Answer 3

carcinomas and sarcomas

Question 4

clinical features of ameloblastoma (conventional)?

Answer 4

benign epithelial odontogenic tumour

2nd most common odontogenic tumour
30-60yr olds
usually posterior mandible
swelling
radiolucent lesion on imaging
slow growing, locally aggressive

Question 5

what are the 2 types of tumour cells that make up ameloblastoma (conventional)?

Answer 5

well-organised peripheral single layer of tall, columnar, pre-ameloblast-like cells
core of loosely arranged cells resembling stellate reticulum

Question 6

what are the 2 patterns of cells found in ameloblastoma (conventional)?

Answer 6

follicular (islands of epithelial cells)
plexiform (long strands of epithelial cells)

set in fibrous stroma

Question 7

what are the types of ameloblastomas?

Answer 7

conventional
unicystic
extraosseous/ peripheral
adenoid
metastasizing

Question 8

treatment for ameloblastoma (conventional)?

Answer 8

complete excision with margin of uninvolved tissue
if excision incomplete, it will recur
long-term follow up

Question 9

why are maxillary ameloblastoma potentially lethal?

Answer 9

they are rare
readily spread through the thin bones of the base of the skull and are difficult to excise

Question 10

clinical features of adenomatoid odontogenic tumours?

Answer 10

benign adenomatoid odontogenic tumour
20-30years old
females>males
maxilla>mandible
majority in canine region
often associated with unerupted permanent tooth
unilocular radiolucency - may mimic dentigerous cyst
most are asymptomatic

Question 11

histopathology of adenomatoid odontogenic tumour?

Answer 11

odontogenic epithelium arranged in solid nodules or rosette-like structures
duct-like structures
eosinophillic amorphous material
minimal fibrous stroma

Question 12

what is the main histopathological feature differentiating ameloblastoma and adenomatoid odontogenic tumour?

Answer 12

ameloblastoma - fibrous stroma
AOT - minimal fibrous stroma

Question 13

treatment for adenomatoid odontogenic tumour?

Answer 13

local excision
recurrence is rare

Question 14

what is an odontoma?

Answer 14

developmental malformation (hamartoma) of dental tissues
contain enamel, dentine and sometimes cementum
painless slow growing lesion

Question 15

what is the most common odontogenic tumour?

Answer 15

compound odontoma

Question 16

where do you find compound odontomas?

Answer 16

anterior maxilla

Question 17

what is a compound odontoma?

Answer 17

lots of tooth-like structures on imaging
fibrous capsule enclosing many separate denticles/ odontoids

Question 18

where do you find complex odontomas?

Answer 18

posterior mandible

Question 19

what are complex odontomas?

Answer 19

irregular mass of hard and soft dental tissues, no tooth resemblance, often a cauliflower like mass
radiopaque mass on imaging
cementum often very scant

Question 20

treatment for odontomas?

Answer 20

enucleation
mature lesions completely enucleated do not recur
incompletely enucleated developing lesions may recur

Question 21

clinical features of cementoblastomas?

Answer 21

benign mesenchymal odontogenic tumours
cementum-like tissue in connection with root of tooth
10-40years
mandible>maxilla (associated with the 6s)
painful swelling
well-defined radiopaque/ mixed density lesion

Question 22

is the tooth of a cementoblastoma still vital?

Answer 22

yes

Question 23

histopathology of cementoblastoma?

Answer 23

dense masses of acellular cementum-like material
fibrous, sometimes vascular stroma
tumour blends with root of tooth

Question 24

treatment for cementoblastoma?

Answer 24

complete excision and removal of tooth
commonly recur if incompletely excised