Soft Tissue Masses Part 1 Flashcards
Describe Epithelial tissue of origin
-Arises from epithelium (surface)
-White, red or mixed
-Smooth, rough, or papillary
Describe Mesenchymal tissue of origin
-Arise from connective tissue (deeper)
-Mass under normal-appearing epithelium
-Often smooth
Fibroma:
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category
-Injury
Etiology
-Reactive hyperplasia of fibrous tissue in response to trauma
Demographics
-Broad demographic range
-Most common “tumor” of the oral cavity
Clinical Presentation
-Smooth-surfaced pink nodule similar in color to surrounding mucosa
-Sessile or pedunculated
-Common on buccal mucosa, labial mucosa, tongue and gingiva
Diagnosis
-Biopsy
Tx
-Excisional biopsy
Peripheral Ossifying Fibroma:
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category
-Injury
Etiology
-Uncertain, but understood to be a reactive process
Demographics
-Teenagers and young adults
-Female predilection
Clinical Presentation
-Nodular, red/pink mass
-May have ulcerated surface (yellow)
-**Occurs exclusively on the gingiva
Diagnosis:
-Biopsy
Tx:
-Excisional biopsy
-Remove any local irritants (plaque and calculus)
-Can recur
Pyogenic Granuloma:
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category:
-Injury
Etiology:
-Exuberant tissue response to local irritation, poor hygiene, or hormonal factors
Demographics:
-Most common in children and young adults
-Female predilection
-Often develop in pregnant women
Clinical Presentation:
-Smooth or lobulated pink/red/purple mass
-Surface often ulcerated (yellow)
-Rapid growth
-Gingiva most common oral site
-Also common on lips, tongue, and buccal mucosa
Diagnosis:
-Biopsy
Tx:
-Excisional biopsy
-Remove any local irritants (plaque and calculus)
-Can recur
Differential diagnosis for localized gingival mass (“bump on the gums”)
*Remember “the 4 P’s”
-“Plain” fibroma
-Peripheral ossifying fibroma
-Pyogenic granuloma
-Peripheral giant cell granulomas
(the vast majority of “bumps on the gums” will be one of these diagnoses)
Peripheral Giant Cell Granuloma:
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category:
-Injury
Etiology:
-Reactive lesion caused by local irritation/trauma
Demographics:
-Broad demographic range
Clinical Presentation:
-Red/blue nodular mass
-Occurs exclusively on gingiva or edentulous alveolar ridge
-May produce “cupping” resorption of alveolar bone
Diagnosis:
-Biopsy
Tx:
-Excisional biopsy
-Remove any local irritants (plaque and calculus)
-Can recur
Inflammatory Fibrous Hyperplasia :
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
“Epulis Fissuratum”
Category:
-Injury
Etiology:
-Tumor-like hyperplasia of inflamed fibrous connective tissue
-Often secondary to ill-fitting dentures
Demographics:
-Biopsy
Clinical Presentation:
-Firm fold(s) of hyperplastic tissue
-Can be pedunculated (leaf-like) or nodular
-Most often in alveolar vestibule
Diagnosis:
-Biopsy
Tx:
-Excisional biopsy
-Remove source of irritation
Mucocele:
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category:
-Injury
Etiology:
-Rupture of salivary gland duct and spillage of mucin
Demographics:
-More common in children and young adults
Clinical Presentation:
-Dome-shaped swelling
-Often bluish hue
-Fluctuant to firm texture
-Can rupture, release fluid, and recur
-Lower labial mucosa most common site
Diagnosis:
-Biopsy (salivary gland neoplasms can mimic mucoceles)
Tx:
-May heal spontaneously
-Excisional biopsy and removal of feeding salivary gland
Ranula
Mucocele occurring on the floor of the mouth
Where won’t a mucocele occur?
Anywhere there is not salivary glands! (*Gingiva, anterior hard palate, dorsal tongue)
Sialolith:
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
“Salivary Stones”
Category:
-Injury
Etiology:
-Deposition of calcium salts around nidus of debris in salivary duct
Demographics:
-Most common in young and middle-aged adults
Clinical Presentation:
-Hard submucosal mass
-Radiopaque mass on radiograph
-Can cause episodic pain
-Often in submandibular gland duct system, upper lip, or buccal mucosa
Diagnosis:
-Clinical and radiographic presentation
Tx:
-Massage out of duct
-Stimulate salivary flow and apply moist heat
-Surgical intervention
Reactive Lymphadenopathy:
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category:
-Infectious
Etiology:
-Reaction to infection (viral, bacterial, fungal)
Demographics:
-Common in all age groups
Clinical Presentation:
-Enlarged, tender lymph nodes
-Mobile upon palpation
-Accompanying symptoms of infection (fever, sore throat, fatigue)
Diagnosis:
-Clinical diagnosis
-Laboratory tests
-Biopsy if persistent
Tx:
-Often self-limiting, resolves with tx of underlying condition
Lymphoid Tissues function
-Recognize and process foreign antigens (viral, bacterial, fungal)
-Respond to antigenic challenges: lymphoid cells proliferate, causing lymphoid hyperplasia
Lymphoid Tissues: head and neck locations
-Cervical lymph nodes
-Lymphoid tissue of Waldeyer’s Ring (tonsils)
-Scattered lymphoid aggregates (oropharynx, soft palate, lateral tongue, floor of mouth)
(typically bilateral)
