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BDS2 HHD - Human Disease > 8. Oral facial & bone neoplasms > Flashcards

8. Oral facial & bone neoplasms Flashcards

1
Q

what is neoplasia?

A

new growth

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2
Q

what is a neoplasm?

A
  • an abnormal growth that exceeds normal
    tissue
  • It is uncoordinated and persists after the cessation of the stimulus that caused it
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3
Q

what categories can neoplasia be divided into?

A
  • malignant
  • benign
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4
Q

characteristics of benign neoplasia
(under a microscope)

1 - differentiation
2 - rate of growth
3 - local invasion
=(refers to the way that the growth affects the surrounding tissue)
4 - metastasis
=(spread from sight of origin to distant sights around the body)

A

1
- Well differentiated
- Looks like tissue of origin with
organised structure

2
- Usually slow

3
- Normally well circumscribed with no invasion (usually capsule around, hence pushes tissue away instead of infiltrating tissues)

4
- Absent
- don’t spread

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5
Q

characteristics of malignant neoplasia
(under a microscope)

1 - differentiation
2 - rate of growth
3 - local invasion
4 - metastasis

A

1
- Un-differentiated or poorly differentiated
- Looks different to tissue of origin
with disorganised structure
- cells may vary in size, may not be adherent to each other, may migrate in unusual ways etc

2
- Likely to be rapid

3
- Invasive with poorly defined margin
- not well encapsulated, irregular
- infiltration into surrounding tissue

4
- Common
- spread
- can happen EG via lymphatic or via blood stream
- EG head + neck cancer, tends to metastasise by the lymphatic and spread to other places EG lungs

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6
Q

Benign VS malignant characteristics (diagram)

A

BENIGN
- capsule around outside
- cells look similar
- evenly spaced cells
- overlying tissue being pushed away as is lesion is expanding
- no signs of invasion

MALIGNANT
- cells of varying size
- outer layer not even and not encapsulated
- invasion as cells are moving downwards into surrounding tissue
- areas of necrosis

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7
Q

why can there be areas of necrosis in a malignant neoplasm?

A
  • as rate of division of cells is so high, it actually outstrips its blood supply, hence parts of lesion and cells within lesion are often starved of blood
  • hence get area of necrotic tissue within lesion
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8
Q

common benign oral neoplasias?

(hint 9)

A
  • most end in ‘oma’ hence hit indicating that it’s benign BUT all don’t
  • Haemangioma
  • Lipoma
  • Fibroepithelial polyp
  • Papilloma
  • Naevus
  • pyogenic granuloma
  • ameloblastoma
  • pleomorphic adenoma
  • bony exostosis
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9
Q

what is Heamangioma?

A
  • Benign vasoformative neoplasm
  • formed from either capillaries OR blood vessels
  • described as either Capillary or cavernous haemangioma if it has large blood filled spaces within it
  • Blanch on pressure
    (full of blood so if press on it, will go paler/ whiter)
  • can be performed by microscope slide
  • May cause troublesome bleeding or cosmetic defect
  • Treat by cryotherapy / sclerotherapy / excision
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10
Q
A

Haemangioma

  • in image = cryotherapy
  • if you were to remove it surgically it would be quite a large area so cryotherapy done
  • sometimes has to be repeated and sometimes doesn’t work so surgery needed
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11
Q

what is a lipoma

A
  • Benign neoplasm of adipose tissue
  • Occur anywhere there is subcutaneous / subdermal fat (EG within oral cavity, on face, neck etc
  • Soft yellow discolouration in oral mucosa or pink with normal overlying mucosa / skin
  • on skin usu feel small, soft, mobile lump
  • Treat with surgical excision as have capsule around outside
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12
Q
A

lipoma

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13
Q

what is Fibroepithelial Polyp (FEP)?

A

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, orthodontic appliance, etc
* Local surgical excision if troublesome
* can be left if no trouble

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14
Q
A

Fibroepithelial Polyp (FEP)

  • smooth surface
  • surrounding mucosa looks normal
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15
Q

what is a papilloma?

A
  • Benign proliferating lesion caused by human papilloma virus (hpv)
  • Most common between age 30 - 50
  • HPV strains 6 and 11 (not cancer inducing type 16 + 18 )
  • Soft palate and tongue most common
  • Local surgical excision or cryotherapy if troublesome or if patient worried
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16
Q
A

Papilloma

17
Q

what is a Melanocytic Naevi?

A
  • usu seen on face around oral cavity
  • 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
    (BUT make sure patient knows surgical excision will leave small scar instead)
18
Q
A

Melanocytic Naevi

19
Q

what is a Pyogenic Granuloma?

A

Reactive hyperplasia of connective tissue (no pus and not a granuloma!!)
* usu due to Low grade irritation, trauma, poor oral hygiene, hormonal change
* Gingiva, buccal mucosa, tongue and lips
* F > M most common in second decade
* during pregnancy
* Local surgical excision (including base or can reoccur) plus improved OH

20
Q
A

Pyogenic Granuloma

21
Q

Ameloblastoma

A
  • 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 (infill may be needed in bone)
  • needs to be carefully monitored as can get into surrounding soft tissues + will be difficult to remove
  • V V rarely metastasise
22
Q
A

Ameloblastoma

23
Q

Pleomorphic Adenoma

A
  • Most common salivary gland tumour 80%
  • Parotid gland commonly affected
  • F>M 2:1
  • Any age but most frequent in 30 - 60 year olds
  • usu mobile and smooth below skin
  • no impact on facial nerve structures
  • Careful surgical excision required
24
Q
A

Pleomorphic Adenoma

  • can get quite large if left for long
  • V V small chance of metastasis (only in larger lesions)
25
Q

Bony Exostosis / Torus

A
  • 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
  • small chance of recurrence
26
Q
A

Bony Exostosis / Torus

27
Q

summary

A
  • 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

BDS2 HHD - Human Disease (21 decks)

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