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85 Cards in this Set

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Parenchyma
Neoplastic tissue
it determines the biological behavior of the neoplasm. Closely resemble the tissue of origin
What are the two neoplastic tissue types of origin?
Parenchyma--- it determines the biological behavior of the neoplasm. Closely resemble the tissue of origin

Stroma-- connective tissue, blood vessels, lymphatics
Stroma
neoplastic tissue type of origin

connective tissue, blood vessels, lymphatics
What is epithelial dysplasia?
a premalignant change with a reversible potential.

Contains enlarge and hyperchromatic nucleii. Increased mitotic figures, no basement membrane invasion
Is there any basement membrane invasion in epithelial dysplasia?
no
What is this...
A premalignant change
reversible
enlarged and hyperchromatic nucleii
increased mitotic figures
no basement membrane invasion
Epithelial dysplasia
90% of oral cancers have ______ lesions
60% have some _______ lesions
Less than 3% are _______
90% of oral cancers have RED lesions
60% have some WHITE lesions
Less than 3% are PURE WHITE
T or F Leukoplakis occurs 60x more frequently than erythroplakia but it far LESS ominous
true
Rate these in order of ominousness... hehe

White
Red
Speckled
Red--erythoplakia
Speckled--leukoplakia
White-- leukoplakia
What are the high risk sites for leukoplakia?
1. floor of the mouth
2. Ventrolateral tongue
3. Lips
How long does it take for squamous cell carcinoma to develop?
a. 6 months
b. 1 year
c. 2 years
d. 5 years
e. 10 years
d. 5 years
Snuff Dippers Keratosis
idiopathic leukoplakia
MB fold and gingiva
White well-demarcated rough and wrinkled mucosa, gingival recession
10-30 years old, while blue collar males
Cigarette Smoking-Related Keratosis
Idiopathic Leukoplakia
Flat or verruciform
Middle aged males
Buccal mucosa, MB fold and floor of the mouth
Smooth white lesion to rough or verruciform
Nicotinic stomatitis is also called...
Pipe and cigar smoking
Pipe and Cigar smoking
malignant potential, not well investigated
LIP cancer where the pipe is held
Nicotinic Stomatitis is a _____ change of both surface and ______ ductal epithelium
Nicotinic Stomatitis is a BENIGN change of both surface and DUCTAL epithelium
What does nicotinic stomatitis lead to?
hyperkeratosis
acanthosis
hyperplastic
dilated salivary ducts
What does nicotinic stomatitis look like?
a. white
b. red
c. white and red
c. white and red spot
In erythroplakia, it is histologically....

49% _______
51% ________
49% mild, moderate, severe dysplasis
51% invasive, squamous cell carcinoma
High risk sites for erythroplakia
floor of the mouth
ventrolateral tongue
soft palate complex
You have a red lesion
It has been determined that it is NOT a hemangioma
What do you do?
Highly likely to be premalignant or malignant...particularly true if smoker and lesion asymptomatic

MANAGE PROMPTLY
what is done for epithelial dysplasic/carcinoma in situ
complete surgical removal with clean margins
Melanoplakia
pigmented patches on the oral mucous membrane
What is carcinoma in situ?
severe epithelial dysplasia FULL thickness of the epithelium with no invasion of the basement membrane
Squamous epithelial tumors
papilloma
squamous cell carcinoma
verrucous carcinoma
basal cell carcinoma
carcinoma in situ
what are two differential diagnosis for PAPILLOMA?
1. werruca vulvaris (common wart)
2. condyloma acuminatum (venereal wart)
Is papilloma a true tumor?
Yes, of squamous epithelium
Cauliflower like lesion
Squamous cell carcinoma
Differential---common wart and venereal wart
Papilloma
What is the most common malignancy of the oral cavity?
Squamous Cell Carcinoma
How fatal is squamous cell carinoma?
50% at 5 years
75% at 10 years

In success, often disfiguring
Most common places for Squamous cell carcinoma is ...
tongue, lateral and ventral
then oropharynx, floor of the mouth and lips
Seen is males 55 years +
T or F The most common presentation of squamous cell carcinoma is a non healing ulcer
yes
Signs and symptoms of SCC
changes in denture fit
trismus
decreased tongue mobilitiy
referred otalgia
loose teeth mimicking severe perio
This is squamous cell carcinoma seen on the lips
solar keratosis
tobacco use
Where is SCC most aggressive?
a. lateral anterior surfaces of the tongue
b. ventral anterior surfaces of the tongue
c. Posterior base of the tongue
c. Posterior base of the tongue
T or F 5 year survival rate for SCC is BELOW 35%
true
SCC is likely to metastasize to regional lymph nodes when it is seen at the base of the tongue
TRUE, 78% do
What is the main risk factor for floor of the mouth SCC?
a. smoking
b. diabetes
c. alcohol
d. unknown
a. smoking
indurated ulcer, often anterior floor of the mouth or can be red, white or mixed.
How do you treat floor of the mouth SCC?
surgery
radiation or alone (because of anatomy of area)
Poor prognosis if metastasis
You find SCC on the buccal mucosa. How likely is that?
less than 3% of the all OSCC
Probbaly from tobacco and chewing betel
Treat with surgery and radiation
5 year survival 28-50%
How does oral squamous cell CA start?
DNA damage
Point mutations leading to changes in irreversible transformation of epithelial cells
Over 80% of SCC patients are ____ users
a. marijuanna
b. tobacco
c. alcohol ab (users)
d.
b. tobacco
T or F Cirrhosis of the liver may significantly affect the risk of oral cancers
true
The following are risk factors for oral cancer
a. sun exposure
b. lichen planus
c. viruses (HPV, herpes)
d. diet
YES all
Tis
carcinoma in situ
T1
tumor is 2 cm or less in greatest dimension
T2
tumor between 2-4 cm
T3
greater than 4 cm in greatest dimension
What is T?
primary tumor
What is N?
Regional Lymph Node
N0
no clinically palpable cervical lymph node but metastasis NOT suspected
N1
palpable homolateral lymph nodes but NOT fixed, metastasis SUSPECTED
N2
Palpable contra or bilateral lymph nodes, not fixed, metastasis suspected
N3
palpable and fixed lymph node, metastasis suspected
What is M?
Distant metastasis
M0
no metastasis
M1
Metastasis other than lymph nodes
What do oral cancer patients mainly die from?
a. infection from lower resistance
b. hemorrhage if tumor erodes the main blood vessels
c. reduced organ function
A and B
T or F Tumors near or crossing midline have worse prognosis from greater likelihood of bilateral node involvement
True
After radiation therapy, the patient will haev compromised vascular bed in bone. Why is this significant?
We need to avoid vasoconstrictors
Patients undergoing radiation therapy and currently taking bisphosphonates should do WHAT (fosfomax)
STOP 3 months prior to extractinos and 3 months after.
The different forms of salivary gland pathology
Reactive
Obstructive
Infectious
Autoimmune
Neoplastic
Major salivary gland
palate
parotid
anywhere there is a salivary gland
Pleomorphic Salivary Gland tumor AKA
Benign Mixed tumors
What is the most common malignant salivary tumor in children?
a. Pleomorphic Ademona
b. adenoid cystic carcnimona
c. Mucoepidermoid Carcinoma
c. Mucoepidermoid Carcinoma
Which of the following does NOT feature an unencapsulated lesion?
a. adenoid cystic carcinoma
b. Warthin's tumor
c. mucoepidermoid carcinoma
b. Warthin's tumor, both mucoepidermoid and adenoid cystic carcinoma are NOT encapsulated.
Which is from a possible metasisis of an ignore dentigerous cyst?

a. Odontogenic myeoma
b. mucoepidermoid carcinoma
c. odontoma
d. ameloblastic fibroma
b. mucoepidermoid carcinoma
Which of the following is a SKIN tumor associated with ROLLED borders and sun exposure
a. Warton's tumor
b. Squamous Cell Carcinoma
c. mucoepidermoid carcinoma
d. basal cell carcinoma
d. basal cell carcinoma
Which of the following is most often associated with PAIN
a. adenoid cystic carcinoma
b. mucoepidermoid carcinoma
c. basal cell carcinoma
d. Warton's tumor
a. adenoid cystic carcinoma
T or F Salivary tumors are typically slow growing
true
Which of the following is NOT a tumor of salivary epithelial origin?
a. calclfying epithelial odontogenic
b. monomorphic ademona
c. adenoid cystic carcinoma
d. pleomorphic adenoma
a. calclfying epithelial odontogenic

however, it is epithelial based, it is of ODONTOGENIC origin
Which of the follow are tumors of connective tissues and which are epithelium?
a. ameloblastoma
b. cementifying and ossifying fibroma
c. calcifying epithelial odontogenic
d. cementoblastoma
e. odontogenic myoma
a. ameloblastoma (E)
b. cementifying and ossifying fibroma (CT)
c. calcifying epithelial odontogenic (E)
d. cementoblastoma (CT)
e. odontogenic myoma (CT)
What has the thickest capsule of any benign lesion?
a. adenamatoid odontogenic tumor
b. ameloblastic carcinoma
c. adenoid cystic carcinoma
d. warton's tumor
a. adenamatoid odontogenic tumor
This lesion presents as radiolucencies with flecks of calcificiation, associated with impacted teeth and tends to most often be in anterior maxilla and females. Epithelium and CT involvement
Adenomatoid Odontogenic Tumor
This lesion is associated with impacted teeth, has radio opaqueness within radio L, of epithelial origin and is a rare slow growing neoplasm
calcifying epithelial odontogenic tumor
This odontogenic neoplasm is of epithelial origin, seen most often in mandible molar ramus area, associated with dentigerous cysts and slow growing, unencapsulated. From remnants of the dentinal lamina
ameloblastoma
This lesion is not typically a true tumor (unless in solid form), uni locular or multi locular, calcifications present. Non aggressive and is treated with enucleation.
Calcifiying Odontogenic Cyst
This tumor is of CT, odontogenic origin. Displays as a radiolucency, poorly defined, causes tooth displacement, honeycombed look, usually in the mandible and is a NON encapsulated lesion.
Odontogenic Myxoma
Which tumor requires enucleation AND tooth removal because of the neoplasm's unique ability to fuse to hard tissues?
a. Cemento-osseous dysplasia
b. Cementoblastoma
c. Adenomatioid odontogenic tumor
d. Cementifying fibromas
b. Cementoblastoma
This tumor causes:
Pain, RO mass at apex of teeth with a RL halo, fuses with dental hard tissues, and seen most often in young adults. Derived from CT
cementoblastoma
What is the most common odontogenic tumor?
a. ameloblastoma
b. odontogenic myxoma
c. ameldoblastic fibroma
d. odotoma
d. odontoma
This tumor:
contains enamel, dentin, cementum and pulp tissue, can clinically manifest as failure of tooth to erupt.
Odontoma
This tumor calls for excision and thorough scaling of the adjacent teeth.
a. cementoblastoma
b.peripheral ossifying fibroma
c. peripheral ameloblastoma
d. odontoma
b. peripheral ossifying fibroma
T or F Cemento-osseous dysplasia and calcifying odontogenic cyst are both NOT true tumors
True
what is the difference between sarcoma and carcinoma?
carcinoma--originated epithelium
sarcoma-- originates CT