Lecture 4 Tumours Of The Orofacial Region

Front 1

What are the 4 broad classifications of odontogenic tumours?

Back 1

Epithelial
Connective
Mixed
Malignant

Front 2

What is the classfication for non-odontogenic jaw tumours?

Back 2

Benign
-tori/exostoses
-osteoma
-other

Malignant
-chondrosarcoma
-osteosarcoma
-myeloma
-lymphoma

Front 3

Classify soft tissue tumours.

Back 3

Benign
- Neural tissue
- Valscular tissue
- Muslce
- Fat

Malignant
-Squamous cell carcinoma
-basal cell carcinoma
-melanoma
-others

Front 4

Ameloblastoma: what is it derived from?

Back 4

residual epithelial componenets of tooth development

Front 5

Ameloblastoma: how common is it?

Back 5

most common clinically significant odontogenic tumour

Front 6

Ameloblastoma: may arise from?

Back 6

remnants of dental lamina (rests of Serres)
Reduced enamel epithelium
Rests of malassez
Basal cells of covering oral epithelium

Front 7

Ameloblastoma: recurrence rate?

Back 7

high if not carefully excised

Front 8

Ameloblastoma:

____ growing locally ____/____ tumours that run a ____ course in most cases causing ____ ____

Back 8

slow
invasive
aggressive
benign
facial deformities

Front 9

Ameloblastoma: four main clinico-pathologic types?

Back 9

conventional (solid and multicystic)
unicystic
peripheral
malignant/carcinoma

Front 10

In Non-Odontogenic tumours what are benign tumours?

Back 10

Tori
Exostosis
Osteoma

Front 11

In Non-Odontogenic tumours what are malignant tumours?

Back 11

chondrosarcoma
osteosarcoma
myeloma
lymphoma

Front 12

Clinical and radiographic features of ameloblastoma:

Most typical radiographic appearance is?

Back 12

Multilocular radiolucent lesion
with
Soap bubble appearance – large locules

Honeycombed – small locules

Front 13

Is there Buccal and lingual cortical expansion in ameloblastoma?

Back 13

yes

Front 14

Ameloblastoma:

Roots of adjacent teeth may/may not show root resorption

Back 14

May

Front 15

Ameloblastoma: True or false? Why?

Always appear as a unilocular radiolucency with regular scalloped margins

Back 15

False

May *occasionally appear as a unilocular radiolucency with *irregular scalloped margins

Front 16

Ameloblastoma: Histopathologic features
» Combination of ____ ____ ____ with ____ change in ____

Back 16

solid tumour islands
cystic
islands

Front 17

Ameloblastoma: Histopathologic features

Cysts may be ____ ____

Back 17

very large

Front 18

Ameloblastoma: Histopathologic features

Tumour islands may show:

Back 18

Follicular pattern of growth
Plexiform pattern of growth

Front 19

Ameloblastoma: Histopathologic features: Follicular pattern of growth

is or is not common?

difficult or easy to recognise?

Back 19

is common

easy to recognise

Front 20

Ameloblastoma: Histopathologic features: Follicular pattern of growth

Islands of epithelium resemble what?

Back 20

the enamel organ

Front 21

Ameloblastoma: Histopathologic features: Follicular pattern of growth

Follicles are located where?

Back 21

in a mature fibrous tissue stroma

Front 22

Ameloblastoma: Histopathologic features: Follicular pattern of growth

Follicles have a core of loosely arranged ____ ____ like epithelium

Back 22

stellate recticulum

Front 23

Ameloblastoma: Histopathologic features: Follicular pattern of growth

Describe the organisation of cells surround the SR like core.

Back 23

A single layer of tall columnar ameloblast-like cells
 Reverse nuclear polarisation
 Subnuclear vacuolation

Front 24

Ameloblastoma: Histopathologic features: Plexiform pattern of growth


Describe what it is

Back 24

 Long anastomosing cords and sheets of odontogenic epithelium
 These are bounded by columnar ameloblast-like
cells
 Surround loosely arranged SR like epithelium
 Supporting stroma is loose and vascular
 Cyst formation is relatively uncommon but there may be stromal degeneration

Front 25

Ameloblastoma: Histopathologic features:

What are microscopic types of cell patterns?

Back 25

 Acanthomatous pattern
 Granular cell pattern
 Basal cell pattern
 Desmoplastic pattern

Front 26

Ameloblastoma: Histopathologic features:

Describe each of :

 Acanthomatous pattern
 Granular cell pattern
 Basal cell pattern
 Desmoplastic pattern

Back 26

» Acanthomatous pattern
 Extensive squamous metaplasia of SR like areas
 Does not indicate more aggressive behaviour

» Granular cell pattern
 SR like epithelium shows granular cell change – cells accumulate lysosomes
 Seen usually in young patients and may be associated with clinically
aggressive tumours

» Basal cell pattern
 Least common type
 Follicles of uniform basaloid cells
 No SR like epithelium centrally in follicles

» Desmoplastic pattern
 Small islands and cords of epithelium in densely collagenised stroma
 Peripherall ameloblast-like cells are inconspicuous

Front 27

Adenomatoid Odontogenic Tumour:

Embedded in what?

Back 27

Mature connective tissue stroma

Front 28

Adenomatoid Odontogenic Tumour:

Arises from what?

Back 28

Remnants of Dental lamina
REE

Front 29

Adenomatoid Odontogenic Tumour: Clinical Features

Accounts for how many percent of odontogenic tumours?

Back 29

2 to 7%

Front 30

Adenomatoid Odontogenic Tumour: Clinical features

Age range?

Back 30

3 to 82

Front 31

Adenomatoid Odontogenic Tumour: Clinical features

More than 2/3 occur in which age group?

Back 31

2nd decade

Front 32

Adenomatoid Odontogenic Tumour: Clinical features'

More common in males or females?

Back 32

Females

Front 33

Adenomatoid Odontogenic Tumour: Clinical features

Occurs intra, extra or both osseously?

Back 33

Exclusively intra-osseously

Front 34

Adenomatoid Odontogenic Tumour: Clinical features

Symptoms?

Back 34

It's asymptomatic

Front 35

Adenomatoid Odontogenic Tumour: radio features

What is the radio feature?

Back 35

Circumscribed, unilocular radiolucency surrounding the crown of an unerupted tooth - most often a maxillary canine

Sometimes show snowflake calcifications

Front 36

Adenomatoid Odontogenic Tumour: radio features

The features are very similar to what other pathology?

Back 36

Dentigerous cyst

Front 37

Calcifying epithelial odontogenic tumour:

Is it aggressive or not aggressive?

Back 37

Locally aggressive

Front 38

Calcifying epithelial odontogenic tumour:

How common?

Back 38

rare

Front 39

Calcifying epithelial odontogenic tumour:

Ages affected?

Back 39

20 to 60

Front 40

Calcifying epithelial odontogenic tumour:

more common in maxilla or mandible?

Back 40

mandible

Front 41

Calcifying epithelial odontogenic tumour:

slow or fast growing?

Back 41

slow growing

Front 42

Calcifying epithelial odontogenic tumour:

Is it painless or painful?

Back 42

painless

Front 43

Calcifying epithelial odontogenic tumour:

It can be ____ or ____

Back 43

Peripheral
Central

Front 44

Calcifying epithelial odontogenic tumour: Histological features?

Back 44

Polyhedral epithelial cells with prominent intercellular bridges
Pleomorphism
Multinucleation
Prominent nuclei
Hyperchromatism
Spherical calcification

Front 45

Ameloblastic fibroma:

True or false?

It is derived from mesenchymal tissues only.

Back 45

False

It is true mixed tumour in which both odontogenic epithelial and mesenchymal tissues are neoplastic

Front 46

Ameloblastic fibroma: Clinical features

Occur in what age group?

Back 46

Young patients
First 2 decades of life

Front 47

Ameloblastic fibroma: Clinical features

Common in which sex?

Back 47

Males than females

Front 48

Ameloblastic fibroma: Clinical features

Symptomatic?

Back 48

Asymptomatic if small

Larger lesions show swelling of the jaw

Front 49

Ameloblastic fibroma: radio features

Unilocular or multilocular radiolucency?

Back 49

Either Uni or multilocular radiolucency

Front 50

Ameloblastic fibroma: Clinical features

More common in maxilla or mandible?

Back 50

Mandible

Front 51

Ameloblastic fibroma: radio features
T/F

25% of cases associated with an unerupted tooth

Back 51

False

75% of cases associated with an unerupted tooth

Front 52

Ameloblastic fibroma: radio features
T/F

Margins are not defined and structures are vital

Back 52

False

Margins are well defined and may be sclerotic

Front 53

Ameloblastic fibroma: radio features
T/F

Smaller lesions usually are not unilocular

Back 53

False

Smaller lesions usually unilocular

Front 54

Differentiate between Ameloblastic Fibro-odontoma and ameloblastic fibroma

Back 54

Amelobloastic fibro-odontoma is ameloblastic fibroma with dentine and enamel

Front 55

Odontome:

What is it?

Back 55

Harmatoma of odontogenic origin

Front 56

Odontomes:

What are two categories?

Back 56

Complex and compound

Front 57

Odontomes:

what is complex odontome?

Back 57

Invaginated odontome and develops as a result of infolding of developing tooth germ

gives rise to conglomerate mass of dentine and enamel

Has no resemblance to a tooth

Front 58

Odontomes:

what is compound odontome?

Back 58

Arises as a result of exuberant proliferation and budding of the dental lamina – gives rise to multiple small tooth-like structures

Front 59

Compund Odontomes: Clinical features

More frequent than complex odontome?

Back 59

Yes

Front 60

Compund Odontomes: Clinical features

When does it occur?

Back 60

first two decades

Front 61

Compund Odontomes: Clinical features

Symptomatic or asymptomatic?

Back 61

asymptomatic

Front 62

Compund Odontomes: Clinical features

What is its size?

Back 62

Small but may grow upto 6cm causing jaw expansion

Front 63

Compund Odontomes: Clinical features

Occurs more common on maxilla or mandible?

Back 63

Maxilla

Front 64

Complex Odontomes: Radio features

Maybe confused with what?

Back 64

osteoma

Front 65

Complex Odontomes: Radio features

Association with what?

Back 65

unerupted teeth

Front 66

Complex Odontomes: Radio features

T/F
Surrounded by a thick radiolucent rim

Back 66

False

thin

Front 67

Complex Odontomes: radio features
T/F
Calcified mass with radiodensity of tooth structure

Back 67

True

Front 68

Complex Odontomes: Clinical features

Location?

Back 68

Molar region

Front 69

Complex Odontomes: Clinical features

Symptomatic?

Back 69

Asymptomatic

Front 70

Complex Odontomes: Clinical features

Detected when? What's the mean detection age?

Back 70

first 2 decades
14

Front 71

Compund Odontomes: Radio features

True/False

It is a single solitary tooth-like structure.

Back 71

False

It's a collection of tooth-like structures of varying in size surrounded by a narrow radiolucency

Front 72

Calcifying odontogenic cyst: Clinical features

location?

Back 72

Intra and extra osseous
Incisor-canine area

Front 73

Calcifying odontogenic cyst: Clinical features

Maxilla or Mandible?

Back 73

Equally likely

Front 74

Calcifying odontogenic cyst: Clinical features

Symptomatic?

Back 74

Asymptomatic with painless swelling

Front 75

Calcifying odontogenic cyst: radio features

List

Back 75

Unilocular radiolucency
Well defined border
Contain radio opacities

Front 76

Myxofibroma:

Origin?

Back 76

odontogenic ectomesenchyme

Front 77

Myxofibroma: Clinical features

Found in which age group?

Back 77

young adults
25 to 30

Front 78

Myxofibroma: Clinical features

Maxilla or mandible?

Back 78

mandible

Front 79

Myxofibroma: Clinical features

symptomatic?

Back 79

Asymptomatic if small
Painless expansion if large lesion

Front 80

Myxofibroma: radio features

Uni ocular or multilocular?

Back 80

Both uni or multilocular radiolucency

Front 81

Cementoblastoma:

Features are identical to what?

Back 81

osteoblastoma

Front 82

Cementoblastoma:

also called?

Back 82

true cementoma

Front 83

Cementoblastoma:
Occurrence?

Back 83

Rare

Front 84

Cementoblastoma:
more common in Mandible or Maxilla?

Back 84

mandible

Front 85

Cementoblastoma:
Location?

Back 85

premolar/molar region

Front 86

Cementoblastoma:

Age group?

Back 86

young adults and children

Front 87

Cementoblastoma:

Symptomatic?

Back 87

Pain and swelling occur in about 2/3rds of patients

Front 88

Cementoblastoma: Radio features

T/F

Fused to only one root

Back 88

False

Fused to one or more roots

Front 89

Cementoblastoma: Radio

T/F

Appears as a radiolucent mass

Back 89

False

radiopaque

Front 90

Cementoblastoma: Radio

T/F

Surrounded by a radio-opaque rim

Back 90

False

Surrounded by a thin radiolucent rim

Front 91

Cementoblastoma: Radio

T/F

Roots are pushed away as the tumour fuses to the root of
the tooth

Back 91

False

Roots are resorbed and tumour fuses to the root of
the tooth