11-Oral Facial amp; Bone Neoplasms PDF.pdf

Neoplasia Chris Sproat 2020 Definition Neoplasia = New growth A neoplasm is an abnormal growth that exceeds normal tissue. It is uncoordinated and persists after the cessation of the stimulus that caused it Characteristic Differentiation (similarity to source tissue) Benign Malignant Well differenti...

Neoplasia Chris Sproat 2020 Definition Neoplasia = New growth A neoplasm is an abnormal growth that exceeds normal tissue. It is uncoordinated and persists after the cessation of the stimulus that caused it Characteristic Differentiation (similarity to source tissue) Benign Malignant Well differentiated Un-differentiated Looks like tissue of origin with Looks different to tissue of origin organised structure with disorganised structure Rate of growth Usually slow Likely to be rapid Local Invasion Normally well circumscribed with no invasion Invasive with poorly defined margin Metastasis Absent Common Benign oral neoplasia Haemangioma Lipoma Fibroepithelial polyp Papilloma Naevus Heamangioma Benign vasoformative neoplasm Capillary or cavernous Blanch on pressure May cause troublesome bleeding or cosmetic defect Treat by cryotherapy / sclerotherapy / excision Cryotherapy uses extreme cold to destroy cancer cells. Haemangioma Lipoma Benign neoplasm of adipose tissue Occur anywhere there is subcutaneous / dermal fat Soft yellow or pink with normal overlying mucosa / skin Treat with surgical excision Lipoma Fibroepithelial Polyp (FEP) Most common benign epithelial tumour of oral cavity Painless flat or pedunculate lesion Uncommon before age 30 Inflammatory hyperplasia due to chronic irritation eg cheek biting Local surgical excision if troublesome Fibroepithelial Polyp (FEP) Papilloma Benign proliferating lesion caused by human papilloma virus Most common between age 30 - 50 HPV 6 and 11 (not cancer inducing type 16 + 18 ) Soft palate and tongue most common Local surgical excision or cryotherapy if troublesome Papilloma HPV induced Melanocytic Naevi Pigmented mole Develop in childhood and early adult life (30 - 40) Runs in families (sun exposure / sun burn) Local surgical excision if troublesome or concern Melanocytic Naevi Pyogenic Granuloma Reactive hyperplasia of connective tissue (no pus and not a granuloma!!) Low grade irritation, trauma, poor oral hygiene, hormonal change Gingiva, buccal mucosa, tongue and lips F > M most common in second decade Local surgical excision (including base) plus improved OH Pyogenic Granuloma Ameloblastoma Benign tumour of odontogenic epithelium 80% in mandible most commonly posterior region Expansion, resorption of adjacent tooth roots Locally invasive (very rarely metastatic spread to lung) Surgical excision with margin / enucleation possible Ameloblastoma Pleomorphic Adenoma Most common salivary gland tumour 80% Parotid gland commonly affected F>M 2:1 Any age but most frequent in 30 - 60 year olds Careful surgical excision required Pleomorphic Adenoma Bony Exostosis / Torus Benign localised peripheral overgrowth of bone Most common in palate and lingual aspect mandible Frequently traumatised due to location and thin mucosa Surgical reduction if functionally / cosmetically problematic Bony Exostosis / Torus Summary Benign neoplasia is common in the oral cavity Slow rate of growth and normality of surrounding structures Many do not need treatment If in doubt monitor with regular review, photos or Xray Refer if concern of potential malignancy