Osteosarcoma and Chondrosarcoma Overview

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Questions and Answers

What is the typical radiographic feature of a nasolabial cyst?

Soft tissue cysts of the upper lip (correct)

Presence of numerous goblet cells

Inverted pear shaped radiolucency

Well-circumscribed along the mandibular arch

What is the primary treatment method for a median mandibular cyst?

Radiation therapy

Antibiotic treatment

Complete surgical excision (correct)

Surgical enucleation

During which decades is the incidence of nasolabial cysts most noted?

2nd and 3rd

4th and 5th (correct)

1st and 2nd

6th and 7th

What type of epithelial lining is found in the nasolabial cyst?

Columnar type with numerous goblet cells Signup and view all the answers

What is the recurrence rate after complete surgical excision of a nasolabial cyst?

Recurrence is rare Signup and view all the answers

What is the primary treatment for well-differentiated osteosarcoma?

En bloc resection Signup and view all the answers

Which of the following features is NOT associated with periosteal osteosarcoma?

Location in the femur Signup and view all the answers

What histopathologic feature is characteristic of chondrosarcoma?

Central ossification with poorly differentiated cartilage Signup and view all the answers

What is a common symptom associated with the extension of chondrosarcomas?

Visual disturbances Signup and view all the answers

In what age group do periosteal osteosarcomas most commonly occur?

Young adults around 20 years Signup and view all the answers

Which of the following best describes the prognosis for well-differentiated osteosarcoma?

Significant local recurrence expected Signup and view all the answers

What is a common radiographic feature of periosteal osteosarcoma?

Radiolucent with poorly defined periphery Signup and view all the answers

Which differential diagnosis is associated with the presence of cartilaginous cap?

Osteochondroma Signup and view all the answers

What is the average age group for patients commonly affected by skeletal bone conditions described?

50-70 years old Signup and view all the answers

What is a common location for the skeletal bone conditions discussed?

Angle and body of mandible Signup and view all the answers

Which of the following is a clinical feature associated with the skeletal conditions mentioned?

Bone swelling Signup and view all the answers

What type of radiographic feature is described in the content?

Poorly marginated, radiolucent defects Signup and view all the answers

Which of the following treatment options is mentioned for skeletal bone conditions?

Surgical excision Signup and view all the answers

What is the prognosis associated with the conditions described?

Dismissal 10% 5-year survival Signup and view all the answers

Which type of cyst is classified as non-odontogenic?

Nasolabial Cyst Signup and view all the answers

Which cyst type can be considered a pseudocyst?

Aneurysmal Bone Cyst Signup and view all the answers

Where are Epstein's pearls typically located?

Midline of the palate Signup and view all the answers

What histopathologic feature is characteristic of Bohn's nodules?

Keratinized stratified squamous epithelium Signup and view all the answers

What is the most common developmental cyst of the jaws?

Dentigerous cyst Signup and view all the answers

What is the typical treatment for Bohn's nodules?

No treatment needed Signup and view all the answers

What causes the formation of a dentigerous cyst?

Accumulation of fluid between remnants of enamel organ Signup and view all the answers

Which treatment is likely to result in the formation of a residual cyst?

Extraction only without curettage Signup and view all the answers

What is a common clinical feature of the lateral periodontal cyst?

Bluish discoloration when large Signup and view all the answers

What is the predominant age group for the lateral periodontal cyst?

Older than 21 years Signup and view all the answers

Which of the following describes the radiographic feature of a lateral periodontal cyst?

Well-delineated round or teardrop shaped unilocular radiolucency Signup and view all the answers

Which type of cyst is identified as a multilocular radiolucency resembling a grape cluster?

Botryoid odontogenic cyst Signup and view all the answers

What is the primary etiology of the lateral periodontal cyst?

Dental lamina remnants within the bone Signup and view all the answers

Which differential diagnosis is associated with a multilocular cyst in the mandibular region?

Odontogenic keratocyst Signup and view all the answers

What histopathological feature is observed in the lateral periodontal cyst?

Nonkeratinized epithelium with glycogen containing clear cells Signup and view all the answers

Study Notes

Osteosarcoma

Periosteal osteosarcoma is less common than parosteal osteosarcoma.
It is usually seen in the upper tibial metaphysis.
It is rarely seen in the jaw.
Male predominance at the age of 20.
Radiographically the cortex of the involved bone is intact and sometimes thickened.
The tumor does not involve the underlying marrow cavity.
Appears radiolucent with poorly defined periphery.
Histopathologically , lobules of poorly differentiated malignant cartilage with central ossification.
Tumor infiltration into cortical bone is minimal, and there is no medullary involvement.
Treatment: En bloc resection or radical excision.
Prognosis: Local recurrence rate can be expected.

Chondrosarcoma

Most common in the maxillofacial area (60%).
It often involves the lateral incisors and canine region, and palate.
Tumors can extend from jaw bones to contiguous structures resulting in pain, visual disturbances, nasal signs, and headaches.
Often seen in older age groups, average age 50-70 years.
Common location: angle and body of mandible.
Other signs include bone pain, loosening of teeth, lip paresthesia, bone swelling, gingival mass, and pathologic fracture.
Radiographically, poorly marginated, radiolucent, irregular, moth-eaten, expansile defects.
Rarely expands cortical bone.
Histopathologically, highly variable depending on tumor type and differentiation grade.
Treatment: Surgical excision, chemoradiotherapy.
Prognosis: Very poor. 10% 5-year survival, 2/3 of patients die within a year.

Odontogenic Cyst

Periapical cyst: Develops at the apex of a non-vital tooth.
Lateral periodontal cyst: Develops in the lateral periodontal space, most commonly in the mandibular canine and premolar region.
Botryoid odontogenic cyst: Rare multilocular cyst with a "grape-like" appearance.
Gingival cyst: Small, non-neoplastic cyst usually found on the alveolar ridge that may be symptomatic.
Gingival cyst of the newborn: Small, keratin-filled cysts found in the newborn's gums.
Dentigerous cyst: Develops around the crown of an unerupted tooth.
Eruption cyst: Cyst that develops around the crown of an erupting tooth.
Glandular odontogenic cyst: Rare cyst involving the mandible.
Odontogenic keratocyst: Benign cyst that can grow aggressively and recur.
Calcifying odontogenic cyst (Gorlin cyst): Benign and frequently associated with the presence of calcifications or dentinoid material.

Non-odontogenic Cyst

Globulomaxillary cyst: A developmental cyst, it arises from tissue remnants between the maxillary lateral incisor, canine, and their respective bud.
Nasolabial cyst: Develops from tissue remnants of the nasolabial groove.
Median mandibular cyst: Rare developmental cyst that develops in the midline of the mandible.
Nasopalatine canal cyst: Develops from remnants of the nasopalatine duct.

Pseudocyst

Aneurysmal bone cyst: Benign osteolytic lesion that is characterized by a blood-filled cavity within the bone.
Traumatic bone cyst: A benign, non-neoplastic lesion that typically occurs in the mandible. It involves the medullary cavity and usually involves bone.
Static (Stafne’s) bone cyst: A well-defined radiolucent lesion that is found in the posterior region of the mandible.
Focal Osteoporotic Bone Marrow Defect: A condition characterized by a loss of bone density in the jawbone

Soft tissue cysts of the neck

Branchial cyst: Develops from remnants of the branchial arches.
Dermoid cyst: Benign cyst that develops from ectoderm and contains skin appendages such as hair and sebaceous glands.

Nasolabial Cyst

It usually appears as a swelling of the upper lip lateral to the midline.
Seen in the 4th and 5th decade.
More frequent in females at a 3:1 ratio.
Common in the canine region or the mucobuccal fold.

Median Mandibular cyst

Thought to be of fissural origin.
Typically present as a well-circumscribed radiolucency along the mandibular arch.
Can be treated with surgical excision.

Nasopalatine Canal Cyst

Arises from embryological remnants of the nasopalatine duct.
Intraosseous lesions present in the midline of the anterior maxilla near the incisive foramen.
Many are inflamed and can cause pain, pressure, drainage, and swelling.

Lateral Periodontal Cyst

Typically seen in adults older than 21 years.
Male predilection.
Associated with vital teeth which are non-mobile and may show root divergence.
May have a bluish discoloration due to fluid content.
Location: mandibular premolar and cuspid region.
Radiographically appears as a well-delineated, round or teardrop shaped unilocular radiolucency between teeth.
Histopathologically lined by non-keratinized epithelium with glycogen-containing clear cells.

Botryoid Odontogenic Cyst

Multilocular cyst with "grape-like" appearance.
A variant of lateral periodontal cyst.
Often seen between mandibular canine and premolar teeth.
Can be treated with surgery.

Gingival Cyst of the Newborn

Multilocular cyst lined by thin stratified squamous epithelium. They are often mistaken for neonatal teeth.
Location: alveolar ridge (Bohn’s nodules), midline of the palate (Epstein’s pearls or palatine cyst of the newborn).
Histopathologically lined by keratinized stratified squamous epithelium with keratin in the lumen.
Often rupture before the patient is 3 months old.

Dentigerous Cyst

Develops from the accumulation of fluid between remnants of the enamel organ.
Often seen in association with an unerupted tooth.
It is the second most common odontogenic cyst.
Treatment involves surgical removal.

Treatment and Prognosis for Cysts

Treatment is usually surgical enucleation.
The nasopalatine canal cyst may require RCT with apicoectomy, or extraction without curettage.
Most cysts have a good prognosis.

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Description

This quiz covers critical aspects of osteosarcoma and chondrosarcoma, including their locations, radiographic features, histopathology, treatment options, and prognosis. Understand the differences and similarities between these two types of bone tumors, focusing on their classifications and clinical significance.