Soft Tissue Masses Part 2 Flashcards
Granular Cell Tumor
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category:
-Neoplastic
Etiology:
-Benign neoplasm derived from Schwann cells
Demographics:
-Female predilection
-Rare in children
Clinical Presentation:
-Sessile submucosal nodule
-Pink, sometimes with yellow hue
-Dorsal tongue most common oral site
Diagnosis:
-Biopsy
Tx:
-Excisional biopsy
Lipoma
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category:
-Neoplastic
Etiology:
-Benign tumor of fate
Demographics:
-Uncommon in children
Clinical Presentation:
-Soft, smooth-surfaced nodule
-Usually yellow, sometimes pink
-Buccal mucosa and buccal vestibule most common oral sites
Diagnosis:
-Biopsy
Tx:
-Excisional biopsy
Hemangioma
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category:
-Neoplastic
Etiology:
-Benign vascular tumor
Demographics:
-Most common tumor of infancy
Clinical Presentation:
-Bright red to dull blue/purple nodule
-60% in head and neck
-More common in females
-Undergo rapid growth for 6-12months, then involute
-90% resolve by age 9
Diagnosis:
-Biopsy
Tx:
-Varies depending on subtype, location and size
Vascular Malformation
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category:
-Developmental
Etiology:
-Structural anomaly of blood vessels
Demographics:
-Present at birth but persist (and may become more apparent) throughout life
Clinical Presentation:
-Can vary from pink/red macule to blue/purple mass
-Presentation varies based on kind of vasculature involved (capillary, venous, arteriovenous)
-Port wine stains (capillary malformations) common on the face
Diagnosis:
-Aspiration (can confirm vascular origin)
-Imaging (angiogram)
-Biopsy
Tx:
-Varies depending on subtype, location and size
Describe Diascopy
-Helpful clinical test
-Use a glass slide to compress a lesion you think may be vascular
-Vascular lesions tend to blanch with pressure (blood is displaced and lesion returns to normal color)
**Not all vascular things will blanch, but if it does, it’s for sure vascular
Neurofibroma
-Mesenchymal tumor
-Benign
-Nerve origin
-Can occur in many parts of the body
-Tongue and buccal mucosa common oral sites
-Treated with excisional biopsy
Schwannoma
-Mesenchymal tumor
-Benign
-Nerve origin
-Tongue most common oral site
-Treated with excisional biopsy
What are the specific trends for salivary gland tumors?
Major Glands
-The larger the gland, the more likely it is to be benign
-The smaller the gland, the more likely it is to be malignant
Minor Glands
-Almost 50/50 chance of being malignant
Describe salivary gland tumors
-Benign or malignant
-Affect major or minor salivary glands
-Common sites for minor salivary gland neoplasms:
1. Hard palate (most common)
2. Soft palate
3. Upper lip
List the 4 most common salivary gland tumors
- Pleomorphic adenoma
- Mucoepidermoid carcinoma
- Polymorphous adenocarcinoma
- Adenoid cystic carcinoma
Pleomorphic Adenoma
-Salivary gland tumor
-Benign
-Most common salivary gland neoplasm
-Can recur
Mucoepidermoid Carcinoma
-Salivary gland tumor
-Malignant
-Most common salivary gland malignancy
-Usually low-grade
Polymorphous Adenocarcinoma
-Salivary gland tumor
-Malignant
-Usually low-grade
-Not found in major salivary glands)
Adenoid Cystic Carcinoma
-Salivary gland tumor
-Malignant
-More aggressive (perineural invasion)
Describe the treatment for salivary gland tumors
-Varies depending on benign vs. malignant, location, histopathologic grade, and clinical stage
-Local surgical excision, wide surgical excision, superficial parotidectomy, or total gland removal with or without neck dissection
Leukemia
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category:
-Neoplastic
Etiology:
-Group of malignancies characterized by overproduction of neoplastic white blood cell
-Originates in bone marrow, then spills over into circulating blood and tissues
Demographics:
-Broad range
Clinical Presentation:
-Fatigue
-Dyspnea
-Splenomegaly
-Hepatomegaly
-Lymphadenopathy
-Easy bruising and bleeding
-Fever
-Diffuse, boggy, nontender swelling of gingiva, with or without ulceration
Diagnosis
-Biopsy
-Bone marrow biopsy
Tx
-Chemotherapy
-Bone marrow transplant
Leukemia Categorization - Clinical Course - Acute vs Chronic
Acute
-More common in children and young adults
-Proliferation of immature WBC
-More aggressive clinical course
Chronic
-Occurs most frequently in middle-aged adults
-Proliferation of mature WBC
-Slowly progressive clinical course
Leukemia - Histogenesis
-Lymphocytic/Lymphoblastic
-Myeloid
Lymphoma
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category
-Neoplastic
Etiology
-Group of malignant tumors of lymph nodes
-Originates in lymph nodes then can become more widely disseminated
Demographics
-Broad range
Clinical Presentation
-Enlarging, nontender, discrete mass in lymph node region
-May have weight loss, fever, night sweats, and pruritus
-Oral nontender, diffuse soft-tissue swelling (most commonly diffuse large B cell lymphoma)
-Most common oral sites are buccal vestibule, posterior hard palate, and gingiva
Diagnosis:
-Biopsy
-Imaging
Tx:
-Chemotherapy
Kaposi Sarcoma
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category:
-Neoplastic
Etiology:
-Vascular malignancy
-Caused by infection with human herpesvirus 8 (HHV8)
Demographics:
-Most commonly seen in patients with AIDS in the US
-Classic form seen in the Mediterranean, eastern Europe, and central equatorial Africa
-Endemic form seen in Africa
-Iatrogenic form seen in recipients of solid organ transplants
-90% in men
Clinical Presentation:
-Multiple blue-purple macules, plaques, and nodules on the face and oral mucosa
-Predilection for hard palate, gingiva, and tongue
Diagnosis:
-Biopsy
Tx:
-Varies, but usually involves management of underlying AIDS (if applicable) and possibly chemotherapy
Metastatic Tumors
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category:
-Neoplastic
Etiology:
-Spread of malignancy from another site
Demographics:
-Middle ages and older adults with cancer
-Men (lung, renal, melanoma)
-Women (breast, genital, kidney, lung)
Clinical Presentation:
-Nodular soft tissue mass resembling hyperplastic or reactive growth
-More than 50% on the gingiva
-In 25% of patients, the primary malignancy is not diagnosed at time of oral metastasis presentation
Diagnosis:
-Biopsy
Tx:
-Management of primary malignancy
-Poor prognosis
Thyroid Gland Enlargement
-Category
-Etiology
-Clinical Presentation
-Diagnosis
-Tx
Category:
-Metabolic, immune-mediated, or neoplastic
Etiology:
-Goiter (most common)
-Thyroid adenoma (benign)
-Thyroid carcinoma (malignant)
-Graves disease
-Hashimoto’s thyroiditis
Clinical Presentation:
-Mass in the anterior midline of the neck
Diagnosis:
-Fine needle aspiration (FNA)
-Imaging
-Bloodwork
Tx:
-Varies based on etiology
Graves Disease - clinical presentation
(Hyperthyroidism)
-Diffuse thyroid enlargement
-Weight loss despite increased appetite
-Tachycardia
-Excessive perspiration
-Warm, smooth skin
-Tremors
-Exophthalmos
Hashimoto’s Thyroiditis - clinical presentation
(Hypothyroidism)
-Lethargy
-Dry, course skin
-Swelling of face and extremities
-Huskiness of voice
-Constipation
-Bradycardia
-Hypothermia
Peripheral Odontogenic Cysts/Tumors
-Category
-Etiology
-Demographics
-Clinical Presentation
-Diagnosis
-Tx
Category:
-Neoplastic
Etiology:
-Odontogenic neoplasms (peripheral ameloblastoma, peripheral calcifying epithelial odontogenic tumor, etc.)
Demographics:
-Broad range
Clinical Presentation:
-Soft tissue mass of the gingiva
Diagnosis:
-Biopsy
Tx:
-Excisional biopsy
