Oral Pathology Soft Tissue Tumors

Front 1

(Traumatic or Irritation) Fibroma:
Clinical features?

Cause?

Back 1

Firm, asymptomatic nodules covered by intact epithelium. Very common lesions.

Trauma or chronic irritation.

Front 2

(Traumatic or Irritation) Fibroma:
Treatment?
Significance?

Back 2

Surgical excision.

Reactive lesion with limited growth potential. No malignant transformation reported.

Front 3

Giant Cell Fibroma:
Clinical features?

Age?
Gender?
Maxilla vs. Mandible?

Back 3

Asymptomatic, sessile or pedunculated papules less than 1 cm in size. Usually a papillary surface.

1st 3 decades.
Female.
Mandible.

Front 4

Giant Cell Fibroma:
Treatment?

Back 4

Conservative surgical excision...rarely recurs.

Front 5

Epulis Fissuratum:
3 other names?

Back 5

1. Denture injury tumor
2. Inflammatory Fibrous Hyperplasia
3. Denture Epulis

Front 6

Epulis Fissuratum:
Clinical Features?

Back 6

Tumor-like hyperplasia of fibrous connective tissue associated with denture flange. Mostly in women. Caused by ill-fitting denture.

Front 7

Epulis Fissuratum:
Treatment?
Significance?

Back 7

Surgical removal of excess tissue and denture should be relined or remade.

Lesion will recur if denture is not fixed.

Front 8

Papillary Hyperplasia:
3 other names?

Back 8

Inflammatory Papillary Hyperplasia

Palatal Papillomatosis

Denture Papillomatosis

Front 9

Papillary Hyperplasia:
Clinical features?

Back 9

Reactive tissue growth that usually develops beneath a denture.
Cobblestone lesion of hard palate.
Red and asymptomatic.

Front 10

Papillary Hyperplasia:
Cause?

Back 10

Soft tissue reaction to ill-fitting denture and probable fungal overgrowth. 20% of denture wearers never take them out.

Front 11

Papillary Hyperplasia:
Treatment?

Back 11

Removal of denture
Anti-fungal

Advanced cases:
Excision of lesion

Front 12

Papillary Hyperplasia:
Significance?

Back 12

Not pre-malignant.
Denture hygiene.

Front 13

Fibrous Histiocytoma:
4 other names?

Back 13

1. Dermatofibroma
2. Sclerosing Hemangioma
3. Fibroxanthoma
4. Nodular Subepidermal Fibrosis

Front 14

Fibrous Histiocytoma:
Ages?
Clinical features?

Back 14

Middle age and older adults.

Painless nodular masses.

Front 15

Fibromatosis & Myofibroma:
Define.

Back 15

Fibromatoses: Fibrous proliferations with biological behavior ranging from benign to malignant.

Myofibroma (myofibromatosis): Similar to above but less aggressive proliferation of myofibroblasts.

Front 16

Fibromatosis & Myofibroma:
Clinical features?

Back 16

Fibromatosis: firm, painless mass, may grow quickly or slowly. Most common in children. Paramandibular soft tissues. Lesions can become large and destroy bone.

Myofibromatosis: Most common in neonates and infants. Firm mass in dermis or subcutaneous tissues of head and neck.

Front 17

Fibromatosis & Myofibroma:
Treatment?

Back 17

Fibromatosis: Surgical excision. 23% recurrence rate.

Myofibromatosis: Local excision.

Front 18

Oral Focal Mucinosis:
Ages?
Gender?
Clinical features?

Back 18

Young adults.
Females.

Smooth, non-ulceraated nodular mass may be lobular.

Front 19

Pyogenic Granuloma (Pregnancy Tumor):
Define.

Back 19

Not pyogenic or a granuloma. Often develop in gingiva of pregnant women.

Asymptomatic, red tumescence that becomes more pink as it ages.

Front 20

Pyogenic Granuloma (Pregnancy Tumor):
Cause?

Back 20

Reactie to trauma or chronic irritation. Not a granuloma or a neoplasm. It's size may be modified by hormonal changes.

Front 21

Pyogenic Granuloma (Pregnancy Tumor):
Treatment?
Significance?

Back 21

Excision.

Untreated lesion will remain indefinately. Recurrence likely if not completely removed.

Front 22

Peripheral Giant Cell Granuloma (Giant Cell Epulis):
Clinical features?

Back 22

Asymptomatic red tumescence of gingiva composed of fibroblasts and multinucleated giant cells.

Front 23

Peripheral Giant Cell Granuloma (Giant Cell Epulis):
Cause?

Back 23

Reactive lesion associated with chronic trauma or irritation.

Front 24

Peripheral Giant Cell Granuloma (Giant Cell Epulis):
Treatment?
Significance?

Back 24

Excision and adjacent teeth should be carefully scaled to remove any source of irritation.

Will remain if not treated.

Front 25

Peripheral Ossifying Fibroma:
3 other names?

Back 25

1. Ossifying Fibroid Epulis
2. Peripheral Fibroma with Calcification
3. Calcifying Fibroblastic Granuloma

Front 26

What is the most common reactive gingival growth?

Back 26

Peripheral Ossifying Fibroma

Front 27

Peripheral Ossifying Fibroma:
Where does it occur?
Color?
Ages?
Sex?
Maxilla vs. Mandible?

Back 27

Exclusively on gingiva, usually in the interdental papilla.

Red to pink.

Young adults.

Female.

Maxilla.

Front 28

Peripheral Ossifying Fibroma:
Treatment?
Prognosis?

Back 28

Local surgical excision.
Scaling to reduce irritants.

Recurrence rate of 16%.

Front 29

Lipoma:
What is it?
Symptomatic?
Circumscribed?
Color?

Back 29

A neoplasm of fat.

Asymptomatic.

Well circumscribed.

Yellow-white.

Front 30

Lipoma:
Cause?
Treatment?
Prognosis?

Back 30

Unknown.

Excision.

Limited growth potential and recurrence is unusual.

Front 31

Traumatic Neuroma:
Another name?
What is it?

Back 31

Amputation Neuroma.

A reactive proliferation of neural tissue following transection or damage to the nerve bundle.

Front 32

Traumatic Neuroma:
Appearance?
Sites?
Ages?
Pain?

Back 32

Smooth, non-ulcerated nodules.

Mental foramen, tongue and lip.

Middle aged adults.

1/4-1/3 with pain.

Front 33

Traumatic Neuroma:
Treatment?
Prognosis?

Back 33

Excision (including small portion of the nerve bundle).

Most do not reoccur.

Front 34

Palisaded Encapsulated Neuroma:
Appearance?
Pain?
Ages?
Common sites?

Back 34

Solitary, smooth, dome-shaped papule or nodule.

Painless.

Adults.

Face, lip, palate.

Front 35

Palisaded Encapsulated Neuroma:
Circumscribed?
What type of cells?
What to look for histologically?

Back 35

Well circumscribed.

Schwann cells.

Wavy and pointed nuclei.
No verocay bodies.

Front 36

Palisaded Encapsulated Neuroma:
Treatment?
Prognosis?

Back 36

Conservative local excision.
Recurrence is rare.

No malignant change.

Front 37

Neurolemoma:
Another name?
What is it?
Common?
Sites?

Back 37

Schwannoma.

Benign neural neoplasm of Schwann cell origin.

Uncommon.

25-48% of cases are in head and neck.

Front 38

Neurolemoma:
Growth?
Circumscribed?
Symptomatic?
Ages?
Most common oral site?

Back 38

Slow growth.

Circumscribed.

Usually asymptomatic.

Young to middle aged adults.

Tongue.

Front 39

Neurolemoma:
What types of tissue?

Back 39

Antoni A and Antoni B tissue.

Front 40

Neurolemoma:
What is a verocay body?
More organized: Antoni A or B?

Back 40

Reduplicated basement membrane and cytoplasmic processes.

Antoni B is less cellular and less organized.

Front 41

Neurolemoma:
Treatment?
Prognosis?

Back 41

Surgical excision.

Rare malignant transformation.

Front 42

Neurofibroma/Neurofibromatosis:
Appearance?
Sites?
Age/Gender?

Back 42

Soft, single or multiple, asymptomatic. Covered by epithelium.

Tongue, Buccal mucosa.

Any age. No gender predilection.

Front 43

Neurofibroma/Neurofibromatosis:
Cause?

Back 43

Unknown.

NF1 (von Recklinghausen) autosomal dominant trait. 1/2 have no family history.

Front 44

Neurofibroma/Neurofibromatosis:
Treatment?
Prognosis?

Back 44

A solitary neurofibroma is excision--no expected recurrence.

Multiple suggest von Reck. disease.

Front 45

Neurofibroma/Neurofibromatosis:
Von Recklinghausen disease:
Symptoms?
Treatment?

Back 45

Multiple neurofibromas with malignant potential. Cafe au lait spots, optic gliomas, lisch nodules and bony lesions.

Manage the complications (no great treatment of disease). Cancer results in about 5%.

Front 46

Multiple Endocrine Neoplasia Type 2B:
2 other names?

Back 46

Multiple Endocrine Neoplasia Type III
Multiple Mucosal Neuroma Syndrome

MEN Type 2B or III

Front 47

Multiple Endocrine Neoplasia Type 2B:
What is the first sign of the condition?
Other clinical features?

Back 47

Neuromas on lips, tongue and buccal mucosa.

Elongated limbs with muscle wasting.
Medullary carcinoma of thyroid.
Hypertension.

Front 48

Multiple Endocrine Neoplasia Type 2B:
Cause?
Treatment?

Back 48

Unknown...autosomal dominant pattern seen.

Concentrate on the medullary carcinoma of the thyroid.

Front 49

Multiple Endocrine Neoplasia Type 2B:
Significance?

Back 49

Prophylactic removal of the thyroid is sometimes advocated.

Hypertension should be carefully controlled.

Front 50

Melanotic Neuroectoderal Tumor of Infancy:
Clinical features?
Cause?

Back 50

Pigmented, radiolucent, benign neoplasm in maxilla of newborns.

Unknown. Tumor cells are of neural crest origin.

Front 51

Melanotic Neuroectoderal Tumor of Infancy:
Treatment?

Back 51

Surgical excision...recurrence is rare.

Front 52

Paraganglioma:
4 other names?

Back 52

1. Carotid body tumor
2. Chemodectoma
3. Glomus Jugulare Tumor
4. Glomus Tympanicum Tumor

Front 53

Paraganglioma:
Of what origin?
Most common site?

Back 53

Neural crest origin.

Carotid body.

Front 54

Paraganglioma:
Histologic findings?
Malignant?

Back 54

Round or polygonal epitheloid cells organized into nests of Zellballen.

Most are benign.

Front 55

Carotid Body Tumor:
Appearance?
Ages?
Cause?

Back 55

Firm, movable masses in neck at carotid bifurcation.

Adults.

Neoplastic transformation of carotid body (chemoreceptor) cells.

Front 56

Carotid Body Tumor:
Treatment?
Prognosis?

Back 56

Surgical excision.

Risky surgery.

Front 57

Granular Cell Tumor:
Appearance?
Color?
Sites?
Age/Gender?

Back 57

Painless, elevated tumescence, with intact epithelium.

Same as surrounding tissue or lighter.

Dorsum of tongue, but possible anywhere.

Rare in children. Females.

Front 58

Congenital Epulis:
2 other names?

Back 58

1. Congenital Epulis of Newborn
2. Congenital Granular Cell Lesion

Front 59

Congenital Epulis:
Appearance?
Cause?
Treatment?
Prognosis?

Back 59

Firm, pedunculated or sessile mass on infant gingiva. Same color or lighter than surrounding gingiva.

Unknown cause.

Excision.

No expected recurrence.

Front 60

What are the most common tumors of infancy?

Back 60

Hemangiomas.

Front 61

Hemangiomas:
M vs. F?
Race?
Sites?
Resolution?

Back 61

Female.

White.

Most in head and neck.

50% completely resolve by 5 years old.

Front 62

Vascular Malformations:
Appearance?

Back 62

Low flow venous malformations have a blue color and are compressible.

Darken with age.

Front 63

Sturge-Weber Angiomatosis:
2 other names?

Back 63

1. Encephalotrigeminal Angiomatosis
2. Sturge Weber syndrome

Front 64

Sturge-Weber Angiomatosis:
What is it?

Back 64

Rare, non-hereditary developmental condition.
Harmartomatous vascular proliferation involving the tissue of brain and face.

Front 65

Sturge-Weber Angiomatosis:
Clinical features?

Back 65

Port wine staining of face.
Possible mental retardation.
Tranline calcifications in radiographs of affected side.
Glaucoma.

Front 66

Sturge-Weber Angiomatosis:
Treatment?
Prognosis?

Back 66

Depends of severity of the case.
Port wine nevi can be laser removed.

Care taken in removal for fear of hemmorhage.

Front 67

Nasopharyngeal Angiofibroma:
What is it?

Back 67

Rare vascular and fibrous tumor-like lesion occuring only in the nasopharynx. Can be destructive.

Front 68

Nasopharyngeal Angiofibroma:
M vs. F?
Ages?
Early symptoms?
Progression?

Back 68

Males.

Adolescents.

Nasal obstruction and epistaxis.

Tumor can extend into adjacent structures. Anterior bowing of the posterior wall of max. sinus.

Front 69

Nasopharyngeal Angiofibroma:
Treatment?
Prognosis?

Back 69

Surgical excision.

Recurrence rate of 20-40%
Rare malignant transformation.

Front 70

Hemangiopericytoma:
What is it?
Benign or Malignant?

Back 70

Rare neoplasm derived from pericytes...most common in lower extremities.

Both...difficult to tell histologically.

Front 71

Hemangiopericytoma:
Gender?
Appearance?
Histologic appearance?
Treatment?

Back 71

No gender predilection.

Slow growing, painless masses, usually red.

Staghorn or antler appearance.

Benign with local excision.
Malignant with more extensive surgery.

Front 72

Lymphangioma:
What are the 3 types?

Back 72

1. Lymphangioma simplex (cap. size)
2. Cavernous lymphangioma (larger vessels)
3. Cystic lymphangioma (with large macroscopic cystic spaces).

Front 73

Lymphangioma:
Sites?
Appearance?
Race?
M vs. F?

Back 73

Anterior 2/3 of tongue.

Spongy, diffuse, painless mass, pebbly surface. Red-blue.

Blacks.

Male.

Front 74

Lymphangioma:
Treatment?
Prognosis?

Back 74

Surgical excision.

Good prognosis if airway is maintained.

Front 75

Leiomyoma:
What is it?
3 Types?

Back 75

Benign neoplasms of smooth muscle. Rare in oral cavity.

Solid, vascular and epithelioid.

Front 76

Leiomyoma:
Age?
Appearance?
Sites?
Treatment?
Prognosis?

Back 76

Any age.

Slow growth. Firm nodules. Asymptomatic. Normal color.

Lips, palate and cheek.

Excision.

No expected recurrence.

Front 77

Rhabdomyoma:
What is it?
2 categories?

Back 77

Benign neoplasm of skeletal muscle.

Adult and fetal.

Front 78

Rhabdomyoma:
Adult version:
Age?
M vs. F?
Sites?

Back 78

Middle age and older.

Male.

Floor of mouth, soft palate and base of tongue.

Front 79

Rhabdomyoma:
Fetal version:
Age?
M vs. F?
Sites?

Back 79

Affects the occasional adult.

Male.

Face and periauricular region.

Front 80

Osseous & Cartilaginous Choristomas:
What is it?
Sites?
Appearance?
M vs. F?

Back 80

A tumor-like growth of microscopically normal tissue in an abnormal location.

Usually in the tongue.

Female.

Front 81

Soft Tissue Sarcomas:
What are they?

Back 81

Rare malignant tumors of the oral/maxilofacial region (1%)

Front 82

Fibrosarcoma:
What are they?
Pain?
Sites?
Age?

Back 82

Malignant tumors of fibroblasts.

Can become very large before producing pain.

Anywhere.

Mostly children and y.adults.

Front 83

Fibrosarcoma:
Treatment?
Prognosis?

Back 83

Excision.

5 year survival rate is 40-70%.

Front 84

Malignant Fibrous Histiocytoma:
Age?
Pain?
Treatment?
Prognosis?

Back 84

Older age groups.

May or may not be painful.

Very aggressive. May require radical surgical resection.

40% have local recurrences and developing metastases within 2 years of diagnosis.

Front 85

Kaposi's Sarcoma:
Cause?
4 presentations?

Back 85

Herpesvirus 8.

1. Classic
2. Endemic (African)
3. Iatrogenic immunosuppresion-associated
4. AIDS related

Front 86

Kaposi's Sarcoma:
3 stages?

Back 86

1. Patch (macular)
2. Plaque
3. Nodular

Front 87

Olfactory Neuroblastoma:
Another name?
What is it?

Back 87

Esthesioneuroblastoma.

A neuroectodermal neoplasm of the upper-nasal vault...shows similarities to neuroblastomas of other parts of the body.

Front 88

Olfactory Neuroblastoma:
Age?
Site?
Symptoms?
Treatment?
Prognosis?

Back 88

Greater than 10 years old.

Cribiform plate...may expand from here.

Nasal obstruction, epistaxis and pain.

Excision, radiation therapy and chemotherapy.

Depends on stage of tumor.

Front 89

Metastases to Oral Soft Tissues:
Common?
Most common sites?
Appearance of lesions?

Back 89

Uncommon.

Gingiva most common, then tongue.

Nodular masses, sometimes ulcerated. Loosening of adjacent teeth may occur.

Front 90

Metastases to the Oral Soft Tissues:
Age?
M vs. F?
Common sites that they metastasize from?

Back 90

Middle age and up.

Male.

Male: Lung, kidney, skin.
Female: Breast, genital organs, lung, bone, kidney.