Oral Pathology Exam 3 Odontogenic Tumors & Neoplasms

Front 1

In the United States, the most common location for the ameloblastoma is?
a) Anterior Maxilla
b) Posterior Maxilla
c) Anterior Mandible
d) Posterior Mandible

Back 1

Posterior Mandible

Front 2

What is the most common clinically significant (not the most common) odontogenic tumor?

Back 2

Ameloblastoma

Front 3

What tissues may Ameloblastomas originate from?

Back 3

Cell rests of enamel organ
Developing enamel organ
Lining of odontogenic cysts
Basal cells of oral mucosa

Front 4

T/F
Ameloblastomas are Slow-growing, locally invasive and runs a benign course

Back 4

True

Front 5

What are the 3 different clinico-radiographic situations requiring different therapeutic considerations and having different prognoses?

Back 5

Conventional Solid/Multicystic 86%
Unicystic 13%
Peripheral or Extraosseous 1%

Front 6

Where are Solid or Multicystic Ameloblastomas typically located?

Back 6

80% Mandible
70% in posterior region

Front 7

How does a Solid or Multicystic Ameloblastoma appear radiographically?

Back 7

Radiolucent lesion which is usually well-circumscribed; it may be unilocular or multilocular (soap-bubble, honeycomb); occasionally an ameloblastoma will be ill defined with a ragged border

Front 8

What are the two most common subtypes of Solid or Multicystic Ameloblastomas?

Back 8

Follicular type - composed of islands of epithelium, which resemble the enamel organ in a mature fibrous connective tissue stroma
Plexiform - composed of long, anastomosing cords or larger sheets of odontogenic epithelium. Its stroma tends to be loose and vascular.

Front 9

T/F
The granular cell type of solid or multicystic ameloblastoma is more Aggressive

Back 9

True

Front 10

Where does the desmoplastic form of Solid or Multicystic ameloblastoma occur most frequently?

Back 10

Anterior Maxilla

Front 11

What race is more frequently affected by solid/multicystic ameloblastomas?

Back 11

Blacks

Front 12

What is the treatment of solid or multicystic ameloblastomas?

Back 12

Enucleation and curettage with a margin of at least 1 cm beyond radiographic limits of the tumor (marginal resection)

Front 13

Who is most commonly affected by Unicystic Ameloblastomas?

Back 13

20s
90% occur in the Mandible usually in the Posterior region

Front 14

How do Unicystic Ameloblastomas appear radiographically?

Back 14

Typically appears as a radiolucency around the crown of an unerupted tooth (most commonly a Mandibular 3rd molar)

Front 15

What are the 3 Unicystic Ameloblastoma histopathologic varients?

Back 15

Luminal: the tumor is confined to the luminal surface of the cyst
Intraluminal/plexiform: the tumor projects from the cystic lining; sometimes resembles the plexiform type of solid/multicystic ameloblastoma
Mural: the tumor infiltrates the fibrous cystic wall

Front 16

What are Peripheral (Extraosseous) Ameloblastomas?

Back 16

Peripheral (Extraosseous) Ameloblastomas occupy the lamina propria underneath the surface epithelium but outside of the bone.

Front 17

Where are Peripheral Ameloblastomas found clinically?

Back 17

Posterior gingival/alveolar mucosa is involved most frequently. There is a slight predilection for the mandible. The buccal mucosa has been reported rarely.

Front 18

What is the treatment and prognosis for Peripheral Ameloblastomas?

Back 18

Patients respond well to local surgical excision
Malignancy is very rare

Front 19

What is the key feature that indicates malignancy in Malignant ameloblastoma and Ameloblastic carcinoma?

Back 19

Metasteses

Front 20

T/F
Malignant Ameloblastoma and Ameloblastic Carcinoma are the same thing.

Back 20

False

Front 21

What is a tumor that shows histologic features of the typical (benign) ameloblastoma in both the primary and secondary deposits?

Back 21

Malignant Ameloblastoma

Front 22

What is a tumor that shows cytologic features of malignancy in the primary tumor, in recurrence and any metastases?

Back 22

Ameloblastic carcinoma

Front 23

After metasteses what is the next most indicative feature of malignancy?

Back 23

Invasiveness

Front 24

Which of the following is the Most likely diagnosis of this radiopaque lesion shown blocking the eruption of an anterior permanent tooth?
a) Mandibular torus
b) Osteoma
c) Compound odontoma
d) Complex odontoma
e) Sialolith

Back 24

Compound odontoma

Compound type is more often in the anterior maxilla, while the complex type occurs more often in the posterior regions of either jaw. The compound type shows apparent tooth shapes while the complex type appears as a uniform opaque mass with no apparent tooth shapes present.
Odontomas may Block the eruption of a permanent tooth and in these cases are often discovered when searching for the missing tooth radiographically

Front 25

Which of the following is the Most likely diagnosis of the peripheral radiopacity observed at the apex of this non-vital tooth?
a) idiopathic osteosclerosis
b) Focal sclerosing osteomyelitis
c) Cementoblastoma
d) Focal cemento-osseous dysplasia
e) Hypercementosis

Back 25

Cementoblastoma

Front 26

Which of the following should head the list of a differential diagnoses for this mixed radiolucent/radiopaque lesion observed in an 18 yr girl?
a) Complex odontoma
b) Ameloblastoma
c) Adenomatoid odontogenic tumor
d) Dentigerous cyst
e) Ameloblastic fibroma

Back 26

Adenomatoid odontogenic tumor
17 yr Female (2:1), Maxillary Canine, Associated with the crown of an unerupted tooth

Front 27

Which of the following should be considered among the differential diagnoses of this multilocular radiolucency?

a) Ameloblastoma
b) Odontogenic Myxoma
c) Ameloblastic Fibroma
d) All of the above
e) A & C only

Back 27

All of the above

Front 28

All of the following statements concerning adenomatoid odontogenic tumors are correct except
a) Are more common in males
b) Usually occur in the second decade of life
c) Are best treated by enucleation
d) Are frequently associated with unerupted teeth
e) Are more common in the anterior maxilla

Back 28

AOTs are Not more common in males

Front 29

Adenomatoid odontogenic tumors are more common in?
a) Maxilla
b) Mandible

Back 29

Anterior portion of Maxilla

Front 30

Which of the following may appear as a mixed radiolucent/radiopaque lesion associated with teeth?
a) Peripheral cementoosseous dysplasia
b) Adenomatoid odontogenic tumor
c) Cementoossifying fibroma
d) A & B
e) All of the above

Back 30

All of the above

Front 31

Adenomatoid odontogenic tumors are
a) rare in females
b) Most common in the mandible of patients over 50 years
c) May appear as mixed radiolucent/radiopaque lesions
d) A & B
e) All of the above

Back 31

May appear as mixed radiolucent/radiopaque lesions
(common in females)

Front 32

Which of the following is the most likely diagnosis for this mixed radiolucent/radiopaque lesion in a 45 yr Man?
a) Adenomatoid odontogenic tumor
b) Ameloblastoma
c) Ameloblastic fibroma
d) Dentigerous cyst
e) Calcifying epithelial odontogenic tumor

Back 32

Calcifying epithelial odontogenic tumor

Front 33

An odontoma is best classified as which of the following?
a) Neoplasm
b) Choristoma
c) Developmental (hamartoma) lesion
d) Inflammatory lesion
e) Immunological lesion

Back 33

A Developmental (hamartoma) Lesion

Front 34

Which of the following is the most common odontogenic tumor?
a) Ameloblastoma
b) Ameloblastic fibroma
c) Odontogenic myxoma
d) Cementifying fibroma
e) Odontoma

Back 34

Odontoma

(ameloblastoma is the most clinically significant)

Front 35

In which of the following does the conventional solid/multicystic ameloblastoma vary from the ameloblastic fibroma?
a) Common radiographic appearance
b) Site of predilection
c) Average age of patient at diagnosis
d) All of the above
e) A & C

Back 35

Average age at diagnosis
Ameloblastoma = 3rd-7th decade
Ameloblastic fibroma = 14 yrs
Both posterior mandible
Both unilocular or multilocular radiolucencies

Front 36

Which of the following statements is true of the adenomatoid odontogenic tumor?
a) They have a female gender predilection
b) They occur most commonly in the posterior mandible
c) They are often encapsulated
d) All of the above
e) A & C only

Back 36

A & C only
They occur 65% maxillary canine region
They have a thick fibrous capsule

Front 37

Which of the following usually presents as a pericoronal radiolucency?
a) Unicystic ameloblastoma
b) Aneurysmal bone cyst
c) Dentigerous cyst
d) All of the above
e) A & C

Back 37

A & C

Front 38

Which of the following lesions may present with more than one radiographic appearance, i.e. radiolucent, mixed and/or radiopaque?
a) Periapical cemento-osseous dysplasia
b) Adenomatoid odontogenic tumor
c) Calcifying odontogenic cyst
d) All of the above
e) A & C only

Back 38

All of the above

Front 39

Peripheral odontogenic fibromas are located on which of the following?
a) Tongue
b) Gingiva
c) Lower lip
d) Hard palate
e) Buccal mucosa

Back 39

Facial gingiva of the mandible

Front 40

Which histological variant of the solid/multicystic ameloblastoma has a predilection for the anterior maxilla and may appear as a mixed (radiolucent/radiopaque) lesion?
a) Acanthomatous
b) Basal cell
c) Follicular
d) Desmoplastic
e) Granular cell

Back 40

Desmoplastic

Front 41

Which of the following is an example of a true mixed tumor in which the epithelial and mesenchymal tissues are both neoplastic?
a) Ameloblastoma
b) Ameloblastic fibroma
c) Odontoma
d) Adenomatoid odontogenic tumor
e) Squamous odontogenic tumor

Back 41

Ameloblastic Fibroma
The tumor is composed of a cell-rich mesenchymal tissue resembling the primitive dental papilla admixed with proliferating odontogenic epithelium

Front 42

Which of the following is seen most commonly in the anterior part of the maxilla?
a) Ameloblastoma, desmoplastic type
b) Ameloblastoma, solid or multicystic type
c) Adenomatoid odontogenic tumor
d) All of the above
e) A & C

Back 42

A & C

(ameloblastoma, solid or multicystic type is found in the posterior mandible)