Pathology and neoplasia of the oral cavity

Question 1

What is palatoschisis

Answer 1

Where lateral palatine processes have failed to fuse in the centre so get communication between oral and nasal cavities

Can lead to starvation and aspiration pneumonia

Question 2

What is the cause of cleft palate in vet med

Answer 2

Mostly unknown idiopathic
May be some genetic component

Question 3

What is prognathia

Answer 3

Protrusion of the lower jaw; may be normal in brachycephalics

Question 4

What is brachygnathia

Answer 4

Shorter than normal lower jaw

Question 5

What is agnathia

Answer 5

Absence of upper and lower jaw

Question 6

What consequences are there of teeth malocclusion

Answer 6

Uneven wear which can expose pulp and cause pain and entry portal for bacteria

Nodular gingival hyperplasia

Question 7

What is nodular gingival hyperplasia

Answer 7

Tooth trauma to the gum (because of malocclusion) leads to non-neoplastic proliferation of the mucosa

Need histopath to differentiate from neoplasia

Question 8

What are the 3 categories of causes of icteric gums

Answer 8

Pre-hepatic i.e haemolysis
Hepatic i.e hepatitis
Post-hepatic i.e obstructive; cholestasis - compression of biliary system

Question 9

What is segmental enamel hypoplasia

Answer 9

= an odontodystrophy where teeth are missing enamel in some parts
Related to damage to ameloblasts in utero/early life

May be related to bitch hyperthermia
Distemper virus in utero or pupply

Question 10

What consequence can we get when there is bacteraemia via tooth infection

Answer 10

Valvular endocarditis

Question 11

What is the underlying cause of gingivitis in most cats

Answer 11

FIV infection since this reduces T lymphocytes so makes them prone to bacterial gingivitis

Question 12

What does cheilitis mean

Answer 12

Inflammation of the lips

Question 13

Description and pathogenesis of ulcerative glossitis in cats

Answer 13

Begins at angle of oral cavity then spread to tongue and causing thickened granulation tissue

Related to mixed viral infection; calicivirus first, also FIV in some cases

Question 14

What is oral eosinophilic granuloma

Answer 14

Part of eosinophilic syndrome
Mostly cats
Starts in lips/frenulum of young adults
Suspected hypersensitivity reaction
Treat with corticostedois

Question 15

What sites do we tend to see oesophageal obstruction at

Answer 15

 Dorsal to larynx
 Thoracic inlet
 Diaphragmatic hiatus

Question 16

Causes of megaoesophagus

Answer 16

Congenital: either idiopathic denervation or persistence of right aortic arch (vascular ring anomaly)

Acquired: dysautonomia, myasthenia gravis

Question 17

What parasite can oesopageal tumours be related to

Answer 17

Spirocerca lupi

Question 18

How do spirocerca lupi parasite cause tumours

Answer 18

Larvae migrate through aorta to oes; adult develops and causes inflammatory response = nodular oesophagitis

Inflammed mesenchymal cells can undergo neoplastic transformation

Question 19

Treatment of oesophageal tumours

Answer 19

Most NOT amenable to surgery

Question 20

Differential diagnoses for oral masses

Answer 20

• NEOPLASIA**
• Gingival hyperplasia; especially in boxer dogs
• Eosinophilic granuloma; cats
• Craniomandibular osteopathy; esp in west highland whites

Question 21

Which dogs breed is especially assocaited with gingival hyperplasia

Answer 21

Boxers

Question 22

Which dog breed is especially assocaited with craniomandibular osteopathy

Answer 22

West highland whites

Question 23

Presenting signs with oral tumours

Answer 23

• Dysphagia
• Halitosis
• Salivation
• Haemorrhage
• Displacement/tooth loss
• Facial swelling

Question 24

What are the two types of benign canine oral tumours

Answer 24

Epulis = peripheral odontogenic fibroma; truly benign

Acanthomatous ameloblastoma/epulis = locally invasive

Question 25

What must we remember when taking an oral tumour biopsy

Answer 25

Avoid necrotic tissue
AVoid reacive gingival hyperplasia
- Aim for ‘healthy tumour’ tissue

Question 26

What is viral papillomatosis

Answer 26

Cause of warts in oral cavity in dogs; doesn’t require treatment since animal will mount appropriate immune response when it matures

Question 27

What is craniomandibular osteopathy

Answer 27

Condition seen in young animals mostly westies
Present with swollen, painful jaw; see massive proliferation of bone associated with mandible on X ray
Resolves spontaneously; give NSAIDs

Question 28

Characteristics of benign fibromatous/ossifying epulis

Answer 28

Common in dogs; rare in cats

= Smooth surfaces slow growing tumours that grow out from jaw and do not cause dental arcade disruption

Made of well differentiated fibroblasts

Treat with surgyer

Question 29

Characteristics of acanthomatous ameloblastoma

Answer 29

Locally aggressive but not metastatic
Smooth surface but does invade bone supporting teeth so get displacement of teeth

epithelial origin
Must remove underlying bone as part of surgery
Radiosensitivity but can lead necrotic bone

Question 30

Ameloblastoma characteristics

Answer 30

Cystic in appearance and arises in younger animals since comes from dental forming organ

Can resect surgically

Question 31

What is the most common malignant oral tumour

Answer 31

Squamous cell carcinoma

Question 32

Characteristics of oral squamous cell carcinomas

Answer 32

Friable, invasive looking tumours; appear like /pink cauliflower’
More rostral arising tumours are less malignant

Treat via surgical removal of some of maxilla/mandible in dogs; harder in cats since don’t tolerate this well

Question 33

Oral fibrosarcoma characteristics

Answer 33

Affects younger dogs, esp retrievers
Get larger bulkier tumours c/f SCC ; very infiltrative of soft tissue but less so of bone

Question 34

Is osteosarcoma more or less malignant in the axial skeleton c/d appendicular

Answer 34

Less

Question 35

Oral malignant melanoma characteristics and predisposition

Answer 35

Mostly seen in older males; esp poodles, pugs, cockers
One of the msot common canine oral malignant tumours

High rate of metastasis so prognosis poor even with surgery

Get tooth displacement and tumour extension to both sides of dental arcade

Question 36

How can animals with tonsillar tumours present

Answer 36

Difficulty swallowing, drooling
Or may be silent and instead get presentation of a large secondary mass in the retropharyngeal lymph node

Question 37

WHat is the most common lingual tumour

Answer 37

Squamous cell carcinoma
Tends to arise around frenulum under mid portion of tongue/floor of mouth and invade up through tongue