Odontogenic Cysts and Tumors

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Questions and Answers

Which odontogenic cyst is most commonly associated with an unerupted mandibular third molar?

  • Dentigerous cyst (correct)
  • Lateral periodontal cyst
  • Odontogenic keratocyst
  • Radicular cyst

What is the most common location for a nasopalatine duct cyst?

  • Mandibular symphysis
  • In the midline of the anterior maxilla (correct)
  • Posterior hard palate
  • Lateral to the midline of the hard palate

Which of the following is considered a benign odontogenic tumor of epithelial origin?

  • Odontogenic myxoma
  • Odontoma
  • Central giant cell granuloma
  • Ameloblastoma (correct)

A 'soap bubble' or 'honeycomb' radiographic appearance is most characteristic of which odontogenic lesion?

<p>Ameloblastoma (B)</p> Signup and view all the answers

Which cyst is NOT classified as an odontogenic cyst?

<p>Nasopalatine duct cyst (D)</p> Signup and view all the answers

What is the definitive treatment for a radicular cyst?

<p>Enucleation or extraction of the associated tooth and curettage (C)</p> Signup and view all the answers

Which of the following odontogenic tumors is of mesenchymal origin?

<p>Ameloblastic fibroma (C)</p> Signup and view all the answers

What is the most common malignancy of the oral cavity?

<p>Squamous cell carcinoma (D)</p> Signup and view all the answers

Leukoplakia is best defined as:

<p>A white plaque that cannot be rubbed off and cannot be clinically or pathologically diagnosed as any other disease. (D)</p> Signup and view all the answers

Erythroplakia, compared to leukoplakia, has a:

<p>Higher malignant transformation rate. (C)</p> Signup and view all the answers

What is the most common site for oral squamous cell carcinoma?

<p>Floor of the mouth and lateral border of the tongue (A)</p> Signup and view all the answers

Which of the following is a risk factor most strongly associated with oral squamous cell carcinoma?

<p>Human papillomavirus (HPV) and tobacco use (D)</p> Signup and view all the answers

Palatal rugae are typically observed in which soft tissue cyst?

<p>Globulomaxillary cyst (D)</p> Signup and view all the answers

A thyroglossal duct cyst is typically located:

<p>In the midline of the neck, anterior to the trachea (A)</p> Signup and view all the answers

Which of the following infant diseases is characterized by bilateral parotid gland swelling?

<p>Mumps (Epidemic Parotitis) (B)</p> Signup and view all the answers

Koplik spots are pathognomonic for which childhood exanthem?

<p>Rubeola (Measles) (C)</p> Signup and view all the answers

Strawberry tongue is a clinical finding associated with:

<p>Scarlet Fever (D)</p> Signup and view all the answers

Herpangina is caused by which group of viruses?

<p>Coxsackieviruses (A)</p> Signup and view all the answers

Which soft tissue cyst is most likely to occur in the floor of the mouth and may elevate the tongue?

<p>Dermoid cyst (C)</p> Signup and view all the answers

A branchial cleft cyst typically arises from which branchial arch?

<p>Second branchial arch (A)</p> Signup and view all the answers

Which of the following is NOT a typical characteristic of an odontogenic keratocyst (OKC)?

<p>Non-keratinized epithelial lining (B)</p> Signup and view all the answers

Ghost cells are a histologic feature commonly associated with which odontogenic tumor?

<p>Calcifying odontogenic cyst (Gorlin cyst) (C)</p> Signup and view all the answers

What is the most common type of odontoma?

<p>Compound odontoma (B)</p> Signup and view all the answers

The 'tombstone' epithelium pattern is histologically associated with:

<p>Calcifying epithelial odontogenic tumor (CEOT) (C)</p> Signup and view all the answers

Which malignancy is most commonly associated with the jaws?

<p>Metastatic carcinoma (D)</p> Signup and view all the answers

Which of the following is a characteristic radiographic feature of osteosarcoma of the jaw?

<p>'Sunburst' periosteal reaction (B)</p> Signup and view all the answers

The most common odontogenic tumor overall is:

<p>Odontoma (A)</p> Signup and view all the answers

Cervical lymphadenopathy is most commonly associated with which type of malignancy in the oral cavity?

<p>Squamous cell carcinoma (B)</p> Signup and view all the answers

What is the best initial diagnostic procedure for a suspected soft tissue cyst?

<p>Fine needle aspiration (B)</p> Signup and view all the answers

Which of the following is a soft tissue cyst that is considered developmental in origin and often presents in the lateral floor of the mouth?

<p>Dermoid cyst (B)</p> Signup and view all the answers

A 'ranula' is a type of:

<p>Mucous retention cyst of the sublingual gland (B)</p> Signup and view all the answers

Which of the following is the most appropriate initial treatment for a mucous extravasation cyst (mucocele)?

<p>Observation, as many resolve spontaneously (C)</p> Signup and view all the answers

What distinguishes a mucous retention cyst from a mucous extravasation cyst (mucocele)?

<p>Presence of an epithelial lining in mucous retention cysts (A)</p> Signup and view all the answers

Which odontogenic tumor is associated with Gardner syndrome?

<p>Odontoma (A)</p> Signup and view all the answers

The 'picket fence' pattern of epithelium is characteristic of which lesion?

<p>Adenomatoid odontogenic tumor (AOT) (C)</p> Signup and view all the answers

Calcifications within an adenomatoid odontogenic tumor (AOT) are often described as:

<p>'Driven snow' calcifications (D)</p> Signup and view all the answers

Which of the following is NOT a common clinical feature of a nasopalatine duct cyst?

<p>Tooth mobility (C)</p> Signup and view all the answers

Which of the following is considered a high-grade salivary gland malignancy?

<p>Adenoid cystic carcinoma (A)</p> Signup and view all the answers

A 'Stafne bone defect' (static bone cavity) is characterized by:

<p>A developmental anomaly containing salivary gland tissue (B)</p> Signup and view all the answers

Which of the following is NOT typically included in the differential diagnosis of an ameloblastoma?

<p>Radicular cyst (D)</p> Signup and view all the answers

The term 'ground-glass' appearance on radiographs is most characteristic of:

<p>Fibrous dysplasia (B)</p> Signup and view all the answers

Which infant disease is caused by Paramyxovirus?

<p>Rubeola (D)</p> Signup and view all the answers

What is the primary treatment modality for ameloblastoma?

<p>Surgical resection with adequate margins (A)</p> Signup and view all the answers

Which of the following odontogenic cysts is most likely to present as a multilocular radiolucency?

<p>Odontogenic keratocyst (B)</p> Signup and view all the answers

What is the primary origin of cells in odontogenic tumors?

<p>Remnants of tooth-forming tissues (C)</p> Signup and view all the answers

Which odontogenic tumor is characterized by enamel and dentin formation, representing a hamartoma rather than a true neoplasm?

<p>Odontoma (B)</p> Signup and view all the answers

What is the most common radiographic finding associated with a dentigerous cyst?

<p>Well-defined unilocular radiolucency around the crown of an unerupted tooth (B)</p> Signup and view all the answers

Which of the following is NOT a typical treatment approach for odontogenic cysts?

<p>Radiation therapy (C)</p> Signup and view all the answers

Anterior maxilla is a common location for which of the following odontogenic tumors?

<p>Adenomatoid odontogenic tumor (A)</p> Signup and view all the answers

Which cyst arises from remnants of Hertwig's epithelial root sheath?

<p>Lateral periodontal cyst (D)</p> Signup and view all the answers

What is the primary treatment modality for a small ameloblastoma?

<p>Curettage or enucleation with peripheral ostectomy (A)</p> Signup and view all the answers

Which radiographic characteristic is LEAST likely to be associated with a benign odontogenic tumor?

<p>Rapid expansion with cortical bone destruction (C)</p> Signup and view all the answers

Which odontogenic tumor is known for its 'tennis racket' or 'honeycomb' histological pattern?

<p>Odontogenic myxoma (C)</p> Signup and view all the answers

A patient presents with a painless swelling in the posterior mandible. Radiographic examination reveals a multilocular radiolucency. Which lesion should be highest in the differential diagnosis?

<p>Ameloblastoma (B)</p> Signup and view all the answers

What is the most significant factor determining the prognosis of malignant odontogenic tumors?

<p>Histologic grade and stage at diagnosis (B)</p> Signup and view all the answers

Which of the following odontogenic cysts is NOT typically associated with an unerupted tooth?

<p>Radicular cyst (B)</p> Signup and view all the answers

What is the recurrence rate of odontogenic keratocysts (OKCs) compared to other odontogenic cysts if treated by simple enucleation?

<p>Higher (D)</p> Signup and view all the answers

Which odontogenic tumor is composed of mature cementum-like tissue directly attached to the root(s) of a vital tooth?

<p>Cementoblastoma (C)</p> Signup and view all the answers

What is the most appropriate initial imaging modality for evaluating a suspected odontogenic cyst or tumor?

<p>Panoramic radiograph (D)</p> Signup and view all the answers

In marsupialization of a cyst, what is the primary goal?

<p>Reduction of cyst size by creating an opening for drainage and decompression (A)</p> Signup and view all the answers

Which odontogenic tumor is associated with Gorlin syndrome (Nevoid Basal Cell Carcinoma Syndrome)?

<p>Odontogenic keratocyst (D)</p> Signup and view all the answers

Ghost cells are a characteristic histologic finding in which of the following odontogenic lesions?

<p>Calcifying odontogenic cyst (D)</p> Signup and view all the answers

Which odontogenic tumor is characterized by amyloid-like material in the stroma and Liesegang ring calcifications histologically?

<p>Calcifying epithelial odontogenic tumor (Pindborg tumor) (C)</p> Signup and view all the answers

Which cyst is located in the soft tissues of the floor of the mouth, above the mylohyoid muscle, and is considered a dermoid cyst variant?

<p>Sublingual dermoid cyst (D)</p> Signup and view all the answers

What is the best approach to manage a residual cyst?

<p>Enucleation and curettage (C)</p> Signup and view all the answers

Which of the following is a malignant odontogenic tumor?

<p>Odontogenic sarcoma (A)</p> Signup and view all the answers

What is the significance of the 'daughter cysts' often associated with odontogenic keratocysts (OKCs)?

<p>They are responsible for the higher recurrence rate. (A)</p> Signup and view all the answers

Which odontogenic tumor typically demonstrates calcifications described as 'driven snow' radiographically?

<p>Adenomatoid odontogenic tumor (C)</p> Signup and view all the answers

What is the most common location within the jaws for ameloblastoma?

<p>Posterior mandible (D)</p> Signup and view all the answers

Which odontogenic cyst is considered a true developmental cyst and not related to inflammation?

<p>Dentigerous cyst (B)</p> Signup and view all the answers

What is the significance of keratinization in the lining of an odontogenic keratocyst?

<p>It is a feature that distinguishes it from other odontogenic cysts and contributes to its aggressive behavior. (A)</p> Signup and view all the answers

Which odontogenic tumor is often associated with an impacted maxillary canine?

<p>Adenomatoid odontogenic tumor (B)</p> Signup and view all the answers

What is the implication of finding ameloblastic epithelium in an odontogenic lesion?

<p>It suggests a lesion with potential for aggressive behavior or recurrence, like ameloblastoma or ameloblastic fibroma. (A)</p> Signup and view all the answers

Which of the following treatments is LEAST likely to be effective for managing an aggressive, recurrent ameloblastoma?

<p>Simple curettage (C)</p> Signup and view all the answers

What is the origin of the epithelial lining in a radicular cyst?

<p>Epithelial rests of Malassez (B)</p> Signup and view all the answers

Which of the following factors is most crucial in differentiating between an odontogenic myxoma and an ameloblastoma radiographically?

<p>Internal structure and trabecular pattern (D)</p> Signup and view all the answers

If a patient presents with multiple odontogenic keratocysts, what systemic condition should be considered?

<p>Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome) (B)</p> Signup and view all the answers

Which of the following is NOT a typical histologic feature of ameloblastoma?

<p>Extensive keratinization within epithelial islands (B)</p> Signup and view all the answers

In managing a large cystic lesion in the mandible, what is the primary advantage of marsupialization over immediate enucleation?

<p>Decreased risk of mandibular fracture and damage to adjacent structures (D)</p> Signup and view all the answers

What is the most likely diagnosis for a radiopaque lesion fused to the root of a mandibular premolar in a young adult, with no associated radiolucency?

<p>Cementoblastoma (A)</p> Signup and view all the answers

Which odontogenic tumor is known for its potential to undergo malignant transformation, although rare?

<p>Ameloblastoma (A)</p> Signup and view all the answers

Which of the following is a key difference between a mucous extravasation cyst (mucocele) and a mucous retention cyst?

<p>Presence or absence of an epithelial lining (C)</p> Signup and view all the answers

Flashcards

Dentigerous Cyst

Arises from rests of dental lamina; most common odontogenic cyst; associated with impacted tooth.

Periapical Cyst (Radicular Cyst)

Inflammatory cyst; arises from periapical region tooth with pulpitis; most common cyst in the jaw.

Lateral Periodontal Cyst

Located between mandibular premolars; arises from rests of dental lamina.

Odontogenic Keratocyst (OKC)

Replaces a tooth; appears similar to dentigerous cyst radiographically.

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Ameloblastoma

Benign but aggressive odontogenic tumor; 'soap bubble' appearance radiographically.

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Odontoma

Most common odontogenic tumor; comprised of enamel, dentin, cementum.

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Nasopalatine Duct Cyst

Located in nasopalatine canal/incisive papilla; heart shape appearance anterior to nasal spine.

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Nasoalveolar Cyst

Soft tissue cyst, no alveolar bone involvement but between max central incisors

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Stafne Bone Cyst

Located inferior to mandibular canal; depression where salivary gland tissue is located.

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Traumatic Bone Cyst

Not a true cyst; proliferation of capillaries.

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Aneurysmal Bone Cyst

Lesion similar to giant cell granuloma, but occurs in long bones.

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Pleomorphic Adenoma

Benign tumor; most common salivary gland tumor; parotid gland most common location

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Mucoepidermoid Carcinoma

The 2nd most common salivary gland tumor; malignant.

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Adenoid Cystic Carcinoma

The most common intraoral site is the palate; malignant.

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Basal Cell Carcinoma

Cancer of the skin.

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Melanoma

Malignant tumor of melanocytes

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Kaposi's Sarcoma

Found in HIV patients, also found in other immunocompromised patients

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Ranula

Swelling in floor of mouth, caused by trauma to sublingual duct

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Sialolith

Calcified mass(es) within major and minor salivary glands.

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Sialadenitis

Inflammation of salivary glands.

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Fordyce Granules

Ectopic sebaceous glands; most common on buccal mucosa/lips.

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Melanin Pigmentation

Hyperpigmentation; genetic, systemic, post-inflammatory.

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Leukoedema

Gray/white area on buccal mucosa

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Lingual Varicosities

Benign anomaly; dilated superficial veins; ventral/lateral tongue.

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Torus Palatinus

Midline of hard palate; genetic/developmental.

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Mandibular Tori

Mandibular premolar area; genetic/developmental.

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Physiologic Pigmentation

Pigmented lesion; must rule out melanoma.

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Congenital Epulis

Mass in newborn; dorsal tongue; benign vascular tumor.

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Fibroma

Most common soft tissue tumor in kids; caused by irritation/trauma.

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Pericoronitis

Inflammation around crown of erupting tooth (3rd molars)

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Abscess

A localized collection of pus in soft tissue, typically caused by a bacterial infection.

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Papilloma

Benign epithelial proliferation with finger-like projections, often resembling a cauliflower.

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Leukoplakia

White patch or plaque that cannot be scraped off and is not attributable to any other diagnosable disease.

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Erythroplakia

Red patch or plaque that cannot be clinically or pathologically identified as any other condition.

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Oral Epithelial Dysplasia

Epithelial dysplasia of the oral mucosa, which may progress to squamous cell carcinoma.

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Squamous Cell Carcinoma

Most common form of oral cancer; often associated with tobacco and alcohol use.

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Polymorphous Adenocarcinoma

Minor salivary gland tumor predominantly on the palate; low-grade salivary malignancy

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Nodule

A raised, nodular lesion often with ulceration that can occur anywhere in the oral cavity.

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Macule

A flattened area differing in color from the surrounding tissue.

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Vesicle

A small blister filled with clear fluid.

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Bulla

A larger fluid-filled blister.

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Study Notes

Odontogenic Cysts and Tumors

  • Odontogenic cysts and tumors are lesions arising from the epithelial and/or mesenchymal remnants of tooth-forming tissues.
  • Their close association with unerupted teeth is a common characteristic, especially in the case of cysts like dentigerous cysts.
  • Common locations for these lesions include the mandible and maxilla, with specific types showing predilections for certain areas.

Radiographic Appearances

  • Radiographically, odontogenic cysts typically appear as well-defined radiolucencies, sometimes unilocular or multilocular.
  • Odontogenic tumors can present with varying radiographic appearances, ranging from radiolucent to mixed radiolucent-radiopaque, depending on the degree of calcification within the lesion.
  • The radiographic appearance can provide important clues regarding the nature of the lesion, aiding in differential diagnosis.

Classification of Odontogenic Cysts

  • Odontogenic cysts are classified based on their origin, either inflammatory or developmental.
  • Inflammatory cysts include periapical cysts and residual cysts, arising due to inflammation secondary to dental caries or trauma.
  • Developmental cysts include dentigerous cysts, odontogenic keratocysts (OKCs), lateral periodontal cysts, and gingival cysts of adults.
  • Dentigerous cysts are associated with the crown of an unerupted tooth.
  • OKCs have a high recurrence rate and can be associated with nevoid basal cell carcinoma syndrome.

Classification of Odontogenic Tumors

  • Odontogenic tumors are classified based on their tissue of origin, either epithelial, mesenchymal, or mixed.
  • Benign epithelial tumors include ameloblastoma, calcifying epithelial odontogenic tumor (CEOT or Pindborg tumor), and adenomatoid odontogenic tumor (AOT).
  • Ameloblastoma is a locally aggressive tumor that can occur in various forms, including solid/multicystic, unicystic, and peripheral types.
  • AOT is typically associated with an unerupted anterior tooth and is more common in young females.
  • Benign mesenchymal tumors include odontogenic myxoma, cementoblastoma, and odontoma.
  • Odontomas are the most common odontogenic tumors, composed of enamel and dentin. They are often asymptomatic.
  • Mixed odontogenic tumors include ameloblastic fibroma and ameloblastic fibro-odontoma.
  • Malignant odontogenic tumors include odontogenic carcinomas and odontogenic sarcomas, which are rare.

Benign vs. Malignant Types

  • Benign lesions are typically slow-growing, well-defined, and do not metastasize.
  • Malignant lesions exhibit aggressive growth, may have ill-defined borders, can invade surrounding tissues, and have the potential to metastasize.
  • Histopathological examination is crucial to differentiate between benign and malignant lesions.

Treatment Options for Cysts

  • Treatment options for odontogenic cysts vary depending on the type, size, and location of the lesion.
  • Small cysts may be treated with enucleation (complete removal of the cyst lining).
  • Larger cysts may require marsupialization (creating a surgical window to reduce the size of the cyst before enucleation) or decompression.
  • For dentigerous cysts, removal of the associated tooth is usually necessary.
  • OKCs may require more aggressive treatment due to their high recurrence rate, including enucleation with peripheral ostectomy or chemical cauterization.

Treatment Options for Tumors

  • Treatment options for odontogenic tumors depend on the type, size, location, and aggressiveness of the lesion.
  • Benign tumors may be treated with surgical excision or enucleation.
  • Ameloblastomas often require wider surgical resection due to their locally aggressive nature.
  • Malignant tumors require aggressive treatment, including wide surgical resection, radiation therapy, and chemotherapy.

Treatment Options for Premalignant Lesions

  • Leukoplakia and erythroplakia are examples of premalignant lesions that can occur in the oral cavity.
  • Treatment options for premalignant lesions include surgical excision, laser ablation, cryotherapy, and topical medications.
  • Regular follow-up is essential to monitor for recurrence or malignant transformation.
  • Biopsy is essential for diagnosis and to rule out malignancy.

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