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Module 7 > ORAL PATH soft tissue neoplasms > Flashcards

ORAL PATH soft tissue neoplasms Flashcards

1
Q

list the types of soft tissue neoplasms?

A

tumours of fibrous tissue
tumours of adipose tissue
tumours of vascular tissue
tumours of peripheral nerves
tumours of muscle

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2
Q

how would you classify majority of intraoral fibrous lesions?

A

benign overgrowths

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3
Q

what is a fibrosarcoma?

A

malignant tumour of fibrous tissue
neoplastic fibroblasts with variable amount of collagen
rare in oral cavity
rarely metastasises

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4
Q

fibrosarcoma treatment?

A

radical excision
can recur

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5
Q

what are the 2 types of tumours of adipose tissue?

A

lipoma (benign)
liposarcoma (malignant)

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6
Q

clinical features of lipoma?

A

soft smooth swelling
pedunculated or sessile
asymptomatic
can be yellowish or pink
buccal mucosa most common intraoral site
pt typically adults 40+

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7
Q

histopathology of lipoma?

A

well-circumscribed lesion
thin capsule
lobules of mature fat cells
bands (septa) or fibrous tissue

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8
Q

lipoma treatment?

A

excision

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9
Q

treatment for liposarcoma?

A

radical excision

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10
Q

list the types of tumours of vascular tissue?

A

haemangioma
lymphangioma
kaposi sarcoma
angiosarcoma

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11
Q

haemangioma clinical features?

A

vascular hamartomatous lesion/ developmental lesions/ benign neoplasm
wide age range
common in children esp females
dark red/ purple swelling
blanch on pressure

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12
Q

what angiomatous syndrome may haemangioma be apart of?

A

sturge-weber syndrome

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13
Q

histopathology of haemangioma?

A

juvenile - very cellular endothelial proliferation
capillary and cavernous depending on size of vascular spaces:
capillary - lots of small blood vessels
cavernous - large blood filled spaces

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14
Q

what may oral haemangiomas involve?

A

muscle, bone and salivary glands

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15
Q

treatment for haemangiomas?

A

haemangiomas in infants/ young children often regress
hamartomatous lesions removal by cryosurgery

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16
Q

clinical features of lymphangioma?

A

rare
pale swelling
often present in childhood
malformation of lymphatic vessels
may be bleeding into lesion
can be localised or diffuse lesion
may present in neck (cystic hygroma)

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17
Q

histopatholgy of lymphangioma?

A

subepithelial collection of dilated lymphatic channels
vessels contain lymph

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18
Q

treatment of lymphangioma?

A

excision

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19
Q

what is Kaposi sarcoma?

A

locally aggressive (intermediate grade) tumour of endothelial cells
associated with HHV-8 infection

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20
Q

what are the 4 variants of kaposis sarcoma?

A

classic
endemic
AIDS-associated
iatrogenic (immunosuppression associated)

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21
Q

clinical features of kaposis sarcoma?

A

palate and gingivae most common IO sites
purplish/ red lesion
becomes increasingly nodular
lesions frequently bleed

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22
Q

treatment for kaposis sarcoma?

A

antiretroviral therapy/ chemotherapy

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23
Q

what is an angiosarcoma?

A

malignant tumour of vascular endothelium
very rare in oral cavity
forehead and scalp of older pts

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24
Q

treatment of angiosarcoma?

A

excision +/- radiotherapy
has poor prognosis

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25
Q

list the types of tumours of peripheral nerves?

A

neurofibroma
neurilemmoma
‘traumatic neuroma’
malignant peripheral nerve sheath tumours (MPNST)

26
Q

clinical features of neurofibroma?

A

benign peripheral nerve sheath tumour
rare in the mouth
smooth painless swelling
affects tongue, gingivae, salivary glands or rarely intraosseous
solitary or multiple
associated with neurofibromatosis-1

27
Q

what disease poses significant risk for malignant transformation of neurofibroma?

A

NF-1

28
Q

histopathology of neurofibroma?

A

mixed cellular components including Schwann cells and intraneural fibroblasts
spindle cells with wavy, dark-staining nuclei and scanty cytoplasm
background of collagen fibres, myxoid stroma and occasional mast cells

29
Q

treatment of neurofibroma?

A

excision
rarely recur

30
Q

clinical features of neurilemmoma (schwannoma)?

A

benign peripheral nerve sheath tumour
schwann cell origin
smooth painless swelling
slow growing
tongue most common site

31
Q

histopathology of neurilemmoma (schwannoma)?

A

encapsulated tumour
spindled cells with palisaded nuclei (antoni A areas)
loose, less cellular connective tissue (antoni B areas)

32
Q

treatment of neurilemmoma (schwannoma)?

A

excision
unlikely to recur

33
Q

clinical features of traumatic neuroma?

A

reactive lesion after nerve damage - NOT a tumour
smooth nodule
tongue, lower lip, salivary gland
history of trauma/ surgery
uncommon
may be painful

34
Q

histopathology of traumatic neuroma?

A

proliferation of nerve bundles
random arrangment

35
Q

treatment of traumatic neuroma?

A

excision

36
Q

what genetic disease are malignant peripheral nerve sheath tumours associated with?

A

NF-1

37
Q

clinical features of malignant peripheral nerve sheath tumours?

A

painful quickly growing mass
mandible, lips, buccal mucosa

38
Q

treatment for malignant peripheral nerve sheath tumours?

A

radical excision +/- adjuvant therapy

39
Q

what are the 2 types of tumours of smooth muscle?

A

leiomyoma (benign)
leiomyosarcoma (malignant)

40
Q

clinical features of leiomyoma?

A

rare in oral cavity
most arise from vascular smooth muscle
slow growing nodule
sometimes painful
lips, tongue, palate, buccal mucosa

41
Q

histopathology of leiomyoma?

A

well-circumscribed proliferation of smooth muscle cells
may be multiple vessels with thickened walls (angioleimyoma)

42
Q

treatment for leiomyoma?

A

local excision
shouldnt recur

43
Q

clinical features of leiomyosarcoma?

A

very rare in oral cavity
older pts
enlarging mass which may be painful
can metastasise

44
Q

treatment for leiomyosarcoma?

A

radical excision +/- adjuvant therapy

45
Q

what are the 2 types of tumours of skeletal muscle?

A

rhabdomyoma (benign)
rhabdomyosarcoma (malignant)

46
Q

what are the 2 types of rhabdomyoma?

A

feotal
adult

47
Q

clinical features of foetal rhabdomyoma?

A

young children (some adults)
very rare
male
swelling face and ear region
proliferation of immature muscle cells

48
Q

what must you distinguish rhabdomyoma from?

A

rhabdomyosarcoma

49
Q

foetal rhabdomyoma treatment?

A

local excision

50
Q

clinical features of adult rhabdomyoma?

A

older male patients
FOM, tongue, soft palate
often large slow growing mass

51
Q

adult rhabdomyoma treatment?

A

local excision
can recur

52
Q

rhabdomyosarcoma clinical features?

A

more frequent in young children
often painless rapidly growing mass
head and neck most common site

53
Q

treatment for rhabdomyosarcoma?

A

radical excision +/- adjuvant therapy

54
Q

what histological patterns are found in rhabdomyosarcoma?

A

embryonal and alveolar

55
Q

granular cell tumour aetiology?

A

unknown
it is a benign neuroectodermal tumour

56
Q

granular cell tumour clinical features?

A

tongue, buccal mucosa, FOM, palate
wide age range, rare in children
f>m
submucosal, smooth painless swelling

57
Q

granular cell tumour histopathology?

A

large eosinophillic cells with granular cytoplasm in subepithelial tissue
unencapsulated
tend to merge with underlying skeletal muscle fibres
marked hyperplasia of overlying epithelium

58
Q

granular cell tumour treatment?

A

excision

59
Q

congenital epulis/ congenital granular cell epulis aetiology?

A

unknown

60
Q

congenital epulis/ congenital granular cell epulis clinical features?

A

pink polypoid mass on alveolar of newborns
anterior maxilla most frequent site
f>m

61
Q

congenital epulis histopathology?

A

mass of large eosinophillic granular cells similar to those seen in granular cell tumour
hyperplasia of overlying epithelium not seen
immunohistochemistry different from granular cell tumour

62
Q

congenital epulis treatment?

A

excision, esp if breathing or feeding difficulties

Module 7 (60 decks)

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