Oral Pathology 2 (Oncology) - Past Paper PDF

ORAL PATHOLOGY 2 (Oncology)​ ​ DMD4B｜DR. JFERNANDEZ｜2ND SEMESTER: PRELIMS MIXED TUMORS (EPITHELIAL AND MESENCHYMAL)...

ORAL PATHOLOGY 2 (Oncology)​ ​ DMD4B｜DR. JFERNANDEZ｜2ND SEMESTER: PRELIMS MIXED TUMORS (EPITHELIAL AND MESENCHYMAL) 1.​ Ameloblastic fibroma and ameloblastic fibroodontoma 2.​ Odontoma 3.​ Ameloblastic odontoma 4.​ Teratoma AMELOBLASTIC FIBROMA AND AMELOBLASTIC FIBROODONTOMA ​ Considered together because of the slight variations except for the presence of odontoma ​ Both are benign mixed odontogenic tumors composed of neoplastic epithelium and mesenchyme LOCATION AGE GENDER RADIOGRAPHIC HISTOPATHOLOGIC DIFFERENTIAL TREATMENT PROGNOSIS FEATURE FEATURE DIAGNOSIS Mandibular molar-ramus Mean age: 12 years No gender predilection the lesions are well – the lesions are For ameloblastic Conservative surgical Good region Upper limit: 40 years circumscribed and are lobulated and usually fibroma procedure usually surrounded by a surrounded by a fibrous -​ Ameloblastoma Recurrence is uncommon -​ Odontogenic sclerotic margin capsule myxoma – tumor mass is -​ Dentigerous cyst may be unilocular or composed of myxoid -​ Odontogenic multilocular and connective tissue keratocyst associated with the crown – In ameloblastic -​ Central giant cell of an impacted tooth fibroodontoma, one or granuloma\ more foci contain enamel histiocytes ameloblastic and dentin For ameloblastic fibroodontoma - an fibroodontoma: opaque focus appears -​ CEOT​ due to odontoma -​ Calcifying odontogenic cyst ameloblastic fibroma - -​ Developing completely lucent odontoma -​ Adenomatoid radiographically odontogenic tumor ​ ​ ​ ​ J.F ABOY 🦷 1  ORAL PATHOLOGY 2 (Oncology)​ ​ DMD4B｜DR. JFERNANDEZ｜2ND SEMESTER: PRELIMS ODONTOMA ​ mixed tumor since it is composed of both epithelial and mesenchymal dental hard tissues ​ can be regarded as hamartoma rather than neoplasm ​ 2 types: ○​ Compound odontoma: appear as numerous miniature or rudimentary teeth ○​ Complex odontoma: appears as amorphous conglomeration of hard tissue LOCATION AGE GENDER CLINICAL FEATURE RADIOGRAPHIC HISTOPATHOLOGIC DIFFERENTIAL TREATMENT PROGNOSIS FEATURE FEATURE DIAGNOSIS maxilla is affected children and young No gender predilection clinical signs compound normal appearing -​ Focal enucleation Good slightly than mandible adult most are suggestive of an odontoma: enamel, dentin and sclerosing No recurrence discovered in the 2nd odontoma -​ Appears as pulp may be seen in osteitis -​ Osteoma compound decade -​ retained numerous tiny these lesions -​ Periapical odontoma: anterior deciduous tooth teeth in a single cemental jaws Age range: extend -​ impacted tooth focus; roots or dysplasia into later adulthood -​ alveolar over the crown -​ Ossifying complex odontoma - swelling of an impacted fibroma posterior jaws -​ asymptomatic tooth -​ Cementoblasto ma Complex odontoma; -​ Appears in the same region but as amorphous opaque mass ​ ​ ​ ​ J.F ABOY 🦷 2  ORAL PATHOLOGY 2 (Oncology)​ ​ DMD4B｜DR. JFERNANDEZ｜2ND SEMESTER: PRELIMS AMELOBLASTIC ODONTOMA ​ Other name; odontoameloblastoma ​ a variant of odontoma ​ characterized by simultaneous occurrence of an ameloblastoma and odontoma ​ rare tumor LOCATION AGE GENDER CLINICAL FEATURE RADIOGRAPHIC HISTOPATHOLOGIC DIFFERENTIAL TREATMENT PROGNOSIS FEATURE FEATURE DIAGNOSIS mandible Any age/children No gender predilection -​ slowly presence of numerous consist of great variety Same with Expect recurrence if expanding radiopaque masses of cells and tissues in ameloblastoma not totally removed lesion a complex distribution -​ facial deformity -​ bone destruction mild pain -​ delayed eruption of teeth TERATOMA ​ Also known as teratoblastoma ​ True neoplasm ​ Not odontogenic in origin (included in odontogenic tumor because of occurrence of teeth in the lesion) LOCATION AGE GENDER CLINICAL FEATURE RADIOGRAPHIC HISTOPATHOLOGIC DIFFERENTIAL TREATMENT PROGNOSIS FEATURE FEATURE DIAGNOSIS Ovaries, testes, Present at birth No gender predilection Usually cystic lesion Made up of different Dermoid cysts Conservative surgical Good mediastinum. with solid thickening in tissue such as hair, excision Retroperitoneal area, the walls of the lesion sweat glands, No recurrence pineal head, neck sebaceous glands, salivary glands and teeth ​ ​ ​ ​ J.F ABOY 🦷 3  ORAL PATHOLOGY 2 (Oncology)​ ​ DMD4B｜DR. JFERNANDEZ｜2ND SEMESTER: PRELIMS NON-ODONTOGENIC TUMORS BENIGN TUMORS OSSIFYING FIBROMA ​ Cementifying fibroma ​ Cementoossifying fibroma ​ Psammomatoid ossifying fibroma ○​ These terms are used when the bony islands in these lesions have a round or spheroidal shape ​ Variant: ○​ Juvenile Ossifying fibroma ​ Children and young adult ​ Fast growing in children ​ Involves paranasal sinuses and periorbital bones LOCATION AGE GENDER CLINICAL FEATURE RADIOGRAPHIC HISTOPATHOLOGIC DIFFERENTIAL TREATMENT PROGNOSIS FEATURE FEATURE DIAGNOSIS Head and neck: seen 3rd and 4th decade of female ​ Slow growing Well-circumscribed, Composed of fibrous ​ Fibrous dysplasia– Surgical removal Good in the jaws and life ​ Asymptomatic Sharply-defined connective tissue with Ossifying fibroma has a using curettage or craniofacial bones ​ Expansile lesion​ border (LUCENT) well-differentiated well-circumscribed enucleation Causing thinning spindle fibroblast radiographic appearance Mandible: of buccal and and the ease of separating premolar-molar cortical plates it from the bone regions ​ Osteoblastoma ​ Focal cementoosseous dysplasia ​ Focal osteomyelitis ​ ​ ​ ​ J.F ABOY 🦷 4  ORAL PATHOLOGY 2 (Oncology)​ ​ DMD4B｜DR. JFERNANDEZ｜2ND SEMESTER: PRELIMS FIBROUS DYSPLASIA ​ is a condition in which normal medullary bone is replaced by an abnormal fibrous connective tissue proliferation in which new non maturing bone is formed. ​ nature of this condition has not been firmly established ​ 2 Forms of Fibrous dysplasia ○​ Monostotic fibrous dysplasia ​ involves one bone ​ much more common ( 80%) than polyostotic form ​ jaw involvement is common ​ body of the mandible ​ other bones: ribs and femur ​ equal gender predilection ​ laboratory values: within normal range ​ serum calcium, phosphorous, and alkaline phosphatase ○​ Polyostotic fibrous dysplasia ​ involves more than one bone ​ diseases that involve this form: ​ Mc-Cune-Albright Syndrome ​ Jaffe-Lichtenstein Syndrome ​ occurs more commonly in females LOCATION AGE GENDER CLINICAL FEATURE RADIOGRAPHIC HISTOPATHOLOGIC DIFFERENTIAL TREATMENT PROGNOSIS FEATURE FEATURE DIAGNOSIS more often in the 1st or 2nd decade of ​ asymptomatic appearance ranges - consist of slight to ossifying fibroma small lesion - no Malignant maxilla than in the life ​ slow from a radiolucent moderate cellular chronic osteomyelitis treatment other transformation is rare Mandible enlargement lesion to a uniformly fibrous connective than biopsy (fewer than 1% of ​ present as a radiopaque mass tissue stroma confirmation and cases) Good may extend to involve unilateral periodic follow-up prognosis the maxillary swelling radiopaque change - Fibrous dysplasia of sinus, zygoma, ​ as the lesion that imparts a​ the jaw showing large lesion - sphenoid bone and grows, facial "ground glass" or fibrillar bony surgical floor of the orbit asymmetry "peau d' orange" trabecular bone that is recontouring becomes effect (not supposed to be evident and may pathognomonic) characteristic of this en bloc resection be the initial condition. for complete presenting most commonly seen removal is complaint in patient with contraindicated ​ displacement of long-standing disease, teeth, is a mottled malocclusion, radiolucent and interference with radiopaque tooth eruption appearance may occur fingerprint bone pattern and superior displacement of the mandibular canal in mandibular lesion important distinguishing feature is the poorly defined radiographic and clinical margins of the lesion ​ ​ ​ ​ J.F ABOY 🦷 5  ORAL PATHOLOGY 2 (Oncology)​ ​ DMD4B｜DR. JFERNANDEZ｜2ND SEMESTER: PRELIMS OSTEOBLASTOMA/ OSTEOID OSTEOMA ​ Osteoblastoma ○​ uncommon primary lesion of bone ○​ lesion greater than 1.5 cm in diameter ​ Osteoid osteoma ○​ represent a smaller version ○​ lesion less than 1.5 cm in diameter LOCATION AGE GENDER CLINICAL FEATURE RADIOGRAPHIC HISTOPATHOLOGIC DIFFERENTIAL TREATMENT PROGNOSIS FEATURE FEATURE DIAGNOSIS arise most often in 2nd decade of life Male (2:1) pain, often quite well circumscribed composed of irregular ​ Cementoblastoma Conservative Good vertebrae and long severe, is usually and have a mixed trabeculae of osteoid ​ ossifying fibroma surgical approach bones 90% of lesions associated with lucent-opaque pattern and immature bone ​ fibrous dysplasia (curettage or local presenting before the osteoid osteoma within a stroma ​ osteosarcoma excision) less common in the age of 30 years a thin radiolucency jaws and other localized swelling may may be noted craniofacial bones occur surrounding a calcified central tumor mass posterior tooth-bearing nocturnal pain is regions of the maxilla relieved by aspirin and mandible are the usual sites of jaw duration of signs and involvement symptoms of osteoblastoma ranges from weeks to years ​ ​ ​ ​ J.F ABOY 🦷 6  ORAL PATHOLOGY 2 (Oncology)​ ​ DMD4B｜DR. JFERNANDEZ｜2ND SEMESTER: PRELIMS OSTEOMA ​ benign tumor that consist of mature, compact, or cancellous bone ​ rare in the jaws ​ cause is unknown (trauma, infection, and developmental abnormalities) ​ Periosteal osteoma - arise on the surface of the bone ​ Endosteal osteoma - develop centrally within bone LOCATION AGE GENDER CLINICAL FEATURE RADIOGRAPHIC HISTOPATHOLOGIC DIFFERENTIAL TREATMENT PROGNOSIS FEATURE FEATURE DIAGNOSIS may arise in maxilla 2nd and 5th decades male usually solitary, except 2 distinct variants ​ exostoses of the Surgical excision good and mandible of life in patients with -​ composed of jaws Gardner's syndrome relatively dense, ​ osteoblastoma facial and skull bones compact bone ​ osteoid osteoma headaches, recurrent with sparse ​ odontoma within the paranasal sinusitis and marrow tissue sinuses opthalmologic -​ consist of complaints have been lamellar noted (depending on trabeculae of the lesion location) cancellous bone with abundant Periosteal osteoma - fibrofatty marrow ​ asymptomatic ​ slow-growing ​ bony (hard masses) ​ asymmetry (when lesions enlarge) Endosteal osteoma - Discovered during routine radiographic examination, as dense,well-circumscri bed radiopacities CHONDROMA ​ Benign cartilaginous tumor of unknown cause ​ Rarely seen in the jaws LOCATION AGE GENDER CLINICAL FEATURE RADIOGRAPHIC HISTOPATHOLOGIC DIFFERENTIAL TREATMENT PROGNOSIS FEATURE FEATURE DIAGNOSIS Maxila– anterior Before ages of 50 Equal incidence ​ Painless Appearance is Consist of well defined Surgical excision No recurrence region years ​ Slowly variable but often lobules of mature good progressive present as an irregular hyaline cartilage Mandible – body and growing radiolucent area symphysis coronoid swelling process and condyle ​ Rarely result in mucosal ulceration ​ ​ ​ ​ J.F ABOY 🦷 7  ORAL PATHOLOGY 2 (Oncology)​ ​ DMD4B｜DR. JFERNANDEZ｜2ND SEMESTER: PRELIMS NAME: ​ LOCATION AGE GENDER CLINICAL FEATURE RADIOGRAPHIC HISTOPATHOLOGIC DIFFERENTIAL TREATMENT PROGNOSIS FEATURE FEATURE DIAGNOSIS ​ ​ ​ ​ J.F ABOY 🦷 8