Soft Tissue Tumors

Dentistry 5000 with A at University of Minnesota - Twin Cities

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By: mia gia
Created: 2011-02-13
Size: 183 flashcards
Views: 6

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Irritation fibroma, description

fibrocollagenous (fibrous Conn Tiss) hyperplasia, caused by trauma

Fibroma, is the most common ......

most common tumor of the oral cavity

Loc, Irritation fibroma

buccal mucosa, tongue, lip

description of irritation fibroma lesion

Color of mucosa or white (hyperkeratosis)

pedunculated or sessile

symptoms only if ulcerated

when does irritation fibroma lesion occur

4th to 6th decades fo life

txt of irritation fibroma

conservative surgical excision

Giant cell fibroma, is it common

common lesion but less common in mouth

when in life does giant cell fibroma

younger age, in comparison to irritation fibroma

Loc, giant cell fibroma

more than half cases - GINGIVA

Nm > Mx

Giant cell fibroma is similar to ...

retrocuspid papilla

histology of giant cell fibroma

"giant" fibroblasts

txt of giant cell granuloma

conservative surgical excision

Epulis Fissuratum, other names

Inflammatory fibrous hyperplasia

Denture injury tumor

description of epulis fissuratum

fibroepithelial hyperplasia, can be ulcerated

single or multiple folds of tissue

small or large

Loc of epulis fissuratum

alveolar and/or vestibular mucosa

F>M

txt of epulis fissuratum

surgical removal, denture relining or remake

Inflammatory Papillary Hyperplasia, description

reactive lesion:

-under denture

-ill fitting denture

-poor oral hygiene

-wearing the denture 24 hours

Loc of Inflammatory Papillary Hyperplasia

Hard Palate

txt or Inflammatory Papillary Hyperplasia

removal of denture, altering the denture

Giant cell fibroma size

<1cm

Fibrous Histiocytoma, description

fibroblastic and histiocytic (macrophages in conn tiss) differentiation

Loc, Fibrous histiocytoma

most common in the skin - dermatofibroma

oral cavity - rare: buccal mucosa and vestibule

what age - fibrous histiocytoma

middle aged and older adults

appearance of fibrous histiocytoma? Pain?

nodular mass of varying size

painless

txt of Fibrous Histiocytoma

local surgical excision

Fibromatosis, description

histologic appearance between benign fibrous lesions and fibrosarcoma

fibromatosis in the soft tissues of the head and neck are called

juvenile aggressive fibromatosis

extrabdominal desmoids

Fibromatosis occurs in whom

children and young adults

Loc of fibromatosis

paramandibular soft tissues

aggressive behavior of fibromatosis

can grow to considerable size, destruction of adjacent bone -> can be seen in radiographs

Fibromatosis, painful?

painless

fibromatosis txt and prognosis post txt

wide excision and 23% recurrence rate

Myofibroma in infants and young children is called

myofibromatosis

Histology of myofibroma

rare spindle cell neoplasm, consists of myofibroblasts (cell with smooth m. and fibroblastic features

Myofibroma affects what region of the body

Head and neck

most common sites of myofibroma in the oral cavity (in order)

Mandible - lips - cheek - tongue

appearance of myofibroma - intrabony

radiolucent in radiograph

myofibroma painful?

painless

Myofibroma occurs in whom

older patients , first 4 decades

txt of myofibroma

local excision, can spontaneously regress

if lesion affects vital or visceral organs can be aggressive and can be fatal

pyogenic granuloma, how common

common tumor like growth of the oral cavity

why does pyogenic granuloma occur

exuberant response to irritation or trauma

could be due to periodontal irritation

appearance of pyogenic granuloma

smooth or lobulated pedunculated mass

pink to red in color

commonly ulcerated

size of pyogenic granuloma

few mm to several cm

Loc of pyogenic granuloma

GINGIVA, other sites affected: tongue, lip

whom does pyogenic granuloma occur in

children and yound adults, F> M

pregnancy tumors

Histology of pyogenic granuloma

not pyogenic, not granuloma

vascular proliferation resembles granulation tissue

mixed inflammatory infiltrate

histology of younger lesions vs older lesions - pyogenic granuloma

younger lesion - very vascular

older lesions - mature and fibrous

txt of pyogenic granuloma

conservative surgical excision, recurs if incompletely excised

irritation also has to be removed

Peripheral Giant Cell Granuloma, caused by

reactive lesion due to local irritation or trauma

Histology of Peripheral Giant Cell Granuloma

resembles CGCG,

giant cells, vascular, hemorrhage

appearance of PGCG

red or reddish blue nodular mass

<2 cm

appearance similar to pyogenic granuloma

when does PGCG age range

5th to 6th decades

F:M, PGCG

F> M

60% - Females

Mn: Mx, PGCG

Mn > Mx

how does PGCG affect bone

cupping resorption of bone

txt of PGCG

local surgical excision down to underlying bone

in diagnosis of PGCG, must exclude

hyperparathyroidism, this is very rare but could have similar appearance

Histology of peripheral ossifying fibroma

similar to pyogenic granuloma but uncertain

appearance of peripheral ossifying fibroma

nodular mass, pedunculated or sessile

location of peripheral ossifying fibroma

interdental papillae, attached gingiva

Mx> Mn

>50% of cases incisor /canine area

txt of peripheral ossifying fibroma

local surgical excision down to periosteum

scaling of adjacent teeth to remove irritants

recurrence rate(post txt) for peripheral ossifying fibroma

16%

whom does peripheral ossifying fibroma

younger adults and teens, F>M

When gingival growth is present what 4 Ps should be included in differential diagnosis FOGG

Peripheral Fibroma

Peripheral Ossifying fibroma

Peripheral Giant Cell Granuloma

Pyogenic Granuloma

Lipoma is commonly found.... less common in ......

most common mesenchymal tumor (trunk, extremities)

Head and Neck

description of lipoma

soft nodular mass -> sessile and less frequently pedunculated

yellow color

lipoma, symptomatic?

no, asymptomatic

Loc, Lipoma

buccal mucosa and vestibule, most common sites

Lipoma common in whom

> 40 yrs, F = M

txt of lipoma

conservative local excision, most of them are superficial and small

List of benign tumors of neural origin - 6

traumatic neuroma

palisaded encapsulated neuroma

schwannoma

neurofibroma

granular cell tumor

melanotic neuroectodermal tumor of infancy

Traumatic Neuroma, cause

reactive proliferation of neural tiss after damage to nerve bundle

appearance of Traumatic neuroma

smooth nodule

Loc of Traumatic neuroma

most common in mental foramen, tongue, lower lip with history of trauma, intgraosseus lesions

age of traumatic neuroma

any age, but mostly mid age

Pain in traumatic neuroma

pain can be intermittent or constant mild or severe

larger nerve - more pain

Palisaded encapsulated neuroma caused by

trauma - major etiological factor

location of palisaded encapsulated neuroma

head and neck

face 90% of cases - mostly nose and cheek

description of palisaded encapsulated neuroma

smooth, painless nodule

whom is palisaded encapsulated neuroma common in whom

more common in adults

F=M

txt of palisaded encapsulated neuroma

conservative surgical excision

Schwannoma other name

neurilemoma

schwannoma, common?

relatively uncommon

Loc of schwannoma

25 to 48% of all cases occur in Head and Neck

schwannoma, pain?

painless

How fast does a schwannoma grow and its associated with what structure?

slow-growing, and arises in association with a nerve trunk

schwannoma symptomatic?

no, asymptomatic and pushes nerve aside when it occurs in part of the nerve

Loc, Schwannoma

TONGUE - most common location

radiographic appearance of schwannoma

intraosseus appearance unilocular or multilocular

schwannoma intrabony tumor causes

pain and parasthesia

Histology of schwannoma

antoni A and antoni B cells

antoni A

streaming fasicles of spindle shaped schwann cells, these cells are often palisaded around acellular eosinophilic areas, called verocay bodies

antoni B

less cellular and organized

Neurofibroma, most common type of ....., arises from

most common type of peripheral nerve tumors,

schwann cells, perineural fibroblasts, other cells

Neurofibroma can be associated with

neurofibromatosis, or it can be solitary (more common)

Neurofibroma, pain?

painless

Loc of Neurofibroma

mostly tongue, gingiva and buccal mucosa

intraosseus lesions

Granular Cell Tumor, shows predilection for what location

oral cavity

Granular cell tumor derived from what cell types

schwann cells

most common loc for granular cell tumor

dorsal surface of tongue - followed by buccal mucosa

in whom does granular cell tumor occur

4th to 6th decades, F:M, 2:1

description of granular cell tumor

asymptomatic sessile nodule

<2cm

pink or yellow color

usually solitary, multiple in some black patients

txt of granular cell tumor

conservative local excision

histology of granular cell tumor

large polygonal cells with abundant pale eosinophilic granular cytoplasm and pale nuclei

cells arranged as sheets

lesion not encapsulated and infiltrates surrounding tissues

overlying epithelium shows acanthosis and pseudoepitheliomatous hyperplasia

Congenital Epulis histologically similar to ....... but different.......

granular cell tumor

ultrastructurally and immunohistochemically

appearance of congenital epulis

pink - red smooth surgace mass of alveolar ridge of new born

size of congenital epulis

small to >7.5 cm

multiple tumors congenital epulis?

multiple tumors in 10% of cases

location in the mouth, congenital epulis

Mx> Mn

lateral incisor and canine

striking gender predilection of congenital epulis

female, 90% cases

congenital epulis txt

surgical excision or spontaneous regression

Melanotic Neuroectodermal Tumor of Infancy, growth rate

rapid growth

MNT when does it occur

first year of life

predilection to what location in mouth

anterior Mx, 2/3 of cases

appearance of MNT

rapidly expanding mass, black or blue in color

what destructive effects does MNT have

destroys bone and displaces associated developing teeth

othe rlocations that MNT can occur

skull, Mn, brain, and testis

characteristics of MNT when it occurs in Mn

Mn - very rare

not as invasive and easily excised

lab tests for MNT

increased vanillylmandelic acid (VMA)

this occurs in other neural crest lesions

what cell type does MNT arise from

neural crest cells

post txt of MNT, recurrence rate

15%

what percent of MNT metastasize

6% - behave like malignancy and metastasize

Benign tumors of vascular origin

hemangioma

lymphangioma

Hemangioma occurs in whom

infancy

growth rate of hemangiomas

rapid growth phase,

gradual involution -> regression, sometimes may disappear

vascular malformations occur

at birth, not recognized until first 8 weeks of life

present at birth and persist throughout lfie

Hemangioma is the most common tumor at

infancy

F:M, hemangioma

3F:M

loc of hemangioma

most common in head and neck (60% of cases)

hemangioma, single or multiple

mostly occurs as single lesions

color of hemangiomas

red/blue

loc of hemangiomas

skin, lip, tongue, and buccal mucosa

what happens to a hemangioma when compressed

blanches

hemangiomas - intraosseus lesions

Mn> Mx

occurs as multilocular radiolucency

when do vascular malformations occur

present at birth and persist throughout life

appearance of vascular malformations is called

port-wine stains- pink or puple macule, that grows proportionally with the patient

older patients - darker lesions that become nodular

what causes port wine stain, and what area does it commonly occur in

capillary malformation occuring most commonly on the face,

especially trigeminal nerve (sturge weber)

sterge weber

characterized by hamartomatous vascular proliferation involving tissues of the brain and face

hemangioma txt

watchful neglect

surgical removal and sclerotherapy (injecting medication into vessels which causes them to shrink, which treats vascular malformations)

Lymphangioma predilection

head and neck (50 - 75%)

three types of lymphangiomas, which is most common

capillary, cavernous, and cystic lymphangiomas

cavernous lymphangiomas

most frequent site for lymphangioma in the oral cavity

anterior 2/3 of tongue, can cause MACROGLOSSIA

appearance of lymphangiomas

pebbly surface, clusters of translucent vesicles

similar to frog eggs

another name of cystic lymphangiomas

cystic hygroma

cystic lymphangiomas occur in

neck (cervical) and axilla

where in the neck does cystic lymphangiomas occur

posterior triangle

describe cystic lymphangioma lesion

soft fluctuant mass

what complication could a cystic lymphangioma of neck cause

extend into mediastinum or upward into oral cavity, extending into the ANT triangle, resulting in resp difficulties or dysphagia

Benign tumors of muscle origin

Leiomyoma

Rhabdomyoma

leiomyoma

benign neoplasm of smooth muscle, mostly originate from vascular smooth muscle

3 types of leiomyoma

solid, vascular, and epithelioid

what percent of oral leiomyomas are vascularl leiomyomas

75%

what age leiomyoma

any age

rate of growth leiomyoma

slow growing mucosal nodule

painful, leomyoma?

painful (vascular leiomyoma)

loc of leiomyoma

lips, tongue, palate, and cheek

Rhabdomyoma, two types

adult and fetal types

adult type rhabdomyoma occurs in

mid aged and older patients

M>F

loc of adult rhabdomyoma

FOM, soft palate, and base of tongue

nodule or mass that grows for many years

fetal rhabdomyoma occurs in

young children with male predilection

loc of fetal rhabdomyoma

face adn periauricular region

ossceus and cartilagenous choistomas, LOC

Tongue (85% cases), especially post tongue near foramen cecum

histology of osseus and cartilagenous choristomas

well circumscribed mass of dense lamellar bone or mature cartilage

dental choristoma

ectopic development of tooth in tongue

soft tissue sarcomas, how common

<1% of cancers in the oral and maxillofacial area

two types of soft tissue sarcomas

rhabdomyosarcoma

kaposi's sarcoma

rhabdomyosarcoma

malignant neoplasm of skeletal muscle origin

rhadbomyosarcoma is the the most common....

most common soft tiss sarcoma in children

comn loc of rhabdomyosarcoma

head and neck - (40% cases)

when does rhabdomyosarcoma occur

1st decade, teenagers and young adults

Male or female, rhabdomyosarcoma

60% in males

describe rhabdomyosarcoma

painless mass that grows rapidsly

rhabdomyosarcoma, LOC

orbit > nasal cavity and nasopharynx

rhabdomyosarcoma, intraoral loc

palate

Kaposi sarcoma types

classic - indolent, old meditteranean or easter european men

endemic - africa, young patients

transplant related

epidemic (AIDS)

oral mestastases occur in

bone and soft tissues

what is the route for metastases in oral tissues

lymphatic and blood bourne routes

batson's plexus

valveless vertebral venous plexus tha tmight allow retrograde spread of tumor cells, bypassing filtration through the lungs

metastasize most common locations

gingiva followed by tongue, from lung and breast

appearance of oral metastases

nodular masses often resembling hyperplastic or reactive growths with occasional ulcerations and loosening of adjacent teeth

About this deck

By: mia gia
Created: 2011-02-13
Size: 183 flashcards
Views: 6

About StudyBlue

“I have used this website for three exams, and I see a huge difference in my test results.”
Naj