soft tissue masses 3

Question 1

fordyce granules category

Answer 1

developmental

Question 2

fordyce granules demographics

Answer 2

present in over 80% of the population

Question 2

fordyce granules etiology

Answer 2

ectopic sebaceous glands

Question 3

fordyce granules clinical presentation

Answer 3

• multiple yellow-white papules
• buccal mucosa and vermillion of the upper lip most common

Question 4

fordyce granules diagnosis

Answer 4

clinical diagnosis

Question 5

fordyce granules treatment

Answer 5

no treatment (variation of normal)

Question 6

varix/varicosities category

Answer 6

developmental

Question 7

varix/varicosities etiology

Answer 7

• superficial dilated and tortuous veins
• weakening of blood vessel walls and loss of tone in supporting connective tissues

Question 8

varix/varicosities demographics

Answer 8

• rare in children
• occurs in 2/3rds of people over 60

Question 9

varix/varicosities clinical presentation

Answer 9

• blue/purple nodules
• may be solitary or multiple
• common on ventral and lateral surfaces of the tongue
• common on lips or buccal mucosa
• can become thrombosed (firm)

Question 10

varix/varicosities diagnosis

Answer 10

• usually a clinical diagnosis can be made
• biopsy for solitary varicosities of the lip and buccal mucosa may be indicated

Question 11

varix/varicosities tx

Answer 11

no treatment needed

Question 12

gingival cyst of the adult category

Answer 12

developmental

Question 13

gingival cyst of the adult etiology

Answer 13

• derived from rests of dental lamina
• soft tissue counterpart of lateral periodontal cyst

Question 14

gingival cyst of the adult demographics

Answer 14

adults

Question 15

gingival cyst of the adult clinical presentation

Answer 15

• painless, domelike swellings
• bluish/gray color
• may cause “cupping out” of alveolar bone
• predilection for mandibular canine and premolar area
• always on facial gingiva/alveolar mucosa

Question 16

gingival cyst of the adult diagnosis

Answer 16

biopsy

Question 17

gingival cyst of the adult treatment

Answer 17

excisional biopsy

Question 18

epidermoid cyst category

Answer 18

developmental

Question 19

epidermoid cyst etiology

Answer 19

keratin-filled cyst arising from hair follicle

Question 20

epidermoid cyst demographics

Answer 20

unusual before puberty

Question 21

epidermoid cyst clinical presentation

Answer 21

• nodular, fluctuant subcutaneous lesion
• white or yellow (red if inflamed)
• common in acne-prone areas of head, neck and back
• NOT found intraorally

Question 22

epidermoid cyst diagnosis

Answer 22

biopsy

Question 23

epidermoid cyst tx

Answer 23

excisional biopsy

Question 24

lymphoepithelial cyst category

Answer 24

developmental

Question 25

lymphoepithelial cyst etiology

Answer 25

occlusion and dilation of a crypt of lymphoid tissue

Question 26

lymphoepithelial cyst demographics

Answer 26

most common in young adults

Question 27

lymphoepithelial cyst clinical presentation

Answer 27

- small submucosal mass - firm or soft palpation - typically white or yellow

Question 28

lymphoepithelial cyst common locations

Answer 28

- floor of mouth - ventral tongue - posterior lateral border of tongue - palatine tonsil - soft palate

Question 29

lymphoepithelial cyst diagnosis

Answer 29

- clinical diagnosis - biopsy

Question 30

lymphoepithelial cyst tx

Answer 30

- do nothing - excisional biopsy

Question 31

lingual thyroid category

Answer 31

developmental

Question 32

lingual thyroid etiology

Answer 32

- ectopic thyroid tissue - failure of thyroid bud to descend normally into neck

Question 33

lingual thyroid demographics

Answer 33

most common in females

Question 34

lingual thyroid clinical presentation

Answer 34

- nodular mass on the post. dorsal tongue - may be accompanied by dysphagia, dysphonia, and dyspnea - 72% accompanied by hypothyroidism

Question 35

lingual thyroid diagnosis

Answer 35

- thyroid scan - avoid biopsy (risk of hemorrhage and may be patient's only functioning thyroid tissue)

Question 36

lingual thyroid tx

Answer 36

- follow up - hormone therapy if necessary (may reduce size of symptomatic lesions)

Question 37

multiple endocrine neoplasia type 2B (MEN2B) category

Answer 37

developmental

Question 38

multiple endocrine neoplasia type 2B (MEN2B) etiology

Answer 38

- RET gene mutation - autosomal dominant inheritance pattern

Question 39

multiple endocrine neoplasia type 2B (MEN2B) clinical presentation

Answer 39

- mucosal neuromas (often 1st sign) --> tend to involve oral cavity --> soft, painless papules or nodules --> primarily on lips and ant. tongue --> also seen on buccal mucosa, gingiva, and palate - medullary thyroid carcinoma - pheochromocytoma (adrenal gland tumor)

Question 40

multiple endocrine neoplasia type 2B (MEN2B) diagnosis

Answer 40

- biopsy of oral lesions - genetic testing

Question 41

multiple endocrine neoplasia type 2B (MEN2B) tx

Answer 41

- preventative thyroidectomy - observation for development of pheochromocytoma

Question 42

neurofibromatosis type 1 (NF1) category

Answer 42

developmental

Question 43

neurofibromatosis type 1 (NF1) etiology

Answer 43

- NF1 gene mutation - autosomal dominant inheritance pattern

Question 44

neurofibromatosis type 1 (NF1) clinical presentation

Answer 44

- multiple neurofibromas of skin and mucosa --> potential to become malignant peripheral nerve sheath tumor - café au lait macules (light brown skin pigmentations) - axillary and inguinal freckling - Lisch nodules (pigmentary defects of iris)

Question 45

neurofibromatosis type 1 (NF1) diagnosis

Answer 45

- biopsy - genetic testing

Question 46

neurofibromatosis type 1 (NF1) tx

Answer 46

- cosmetic excision of neurofibromas (if possible) - monitoring for signs of malignant peripheral nerve sheath tumor