Benign Bone Neoplasms

Question 1

Central Ossifying Fibroma is an unccomon benign neoplasm that has been confused with ________ due to female mandibular premolar-molar predilection.

Answer 1

focal cemento-osseous dysplasia

Question 2

What is the cell of origin for Central Ossifying Fibroma?

Answer 2

questionable?

Thought to be: PDL or Odontogenic

Question 3

True or False: Central ossifying fibromas are slow-growing neoplasms.

Answer 3

True

Question 4

Radiographically, how can you differentiate between Cemento-Osseous Dysplasia and Central Ossifying FIbroma?

Answer 4

COD is in tooth bearing areas only (above IAN)

COF can occur in non-tooth bearing areas

Question 5

Which is easier to remove: Central ossifying Fibromas or Cemento-osseous Dysplasias?

Answer 5

Fibromas: they come out as a whole (looks like a potato)
Dysplasia: chips out in pieces

Question 6

What is the prognosis of Central Ossifying Fibroma?

Answer 6

excellent

uncommon recurrence

Question 7

Which syndrome has several jaw lesions that are histologically consistent with central ossifying fibroma?

Answer 7

hyperparathyroidism-jaw tumor syndrome

Question 8

Which bones are affected by osteoma?

Answer 8

membranous bones (bones of the head)

• surfaces of bone
• or inside the bone: dense bone islands

Question 9

________ involvement is more common for Osteoma than gnathic lesions.

Answer 9

Paranasal Sinus (frontal, ethmoid, maxillary)

Question 10

True or False: Tori and exostoses are histologically identical to osteomas.

Answer 10

True

Question 11

An osteoma is composed of dense bone, with only minimal _____ elements.

Answer 11

marrow

Question 12

Where are osteomas most often found?

Answer 12

in the mandibular BODY and CONDYLE of adults

less common: angle, coronoid, ramus

Question 13

True or False: Osteomas involving the mandibular body are frequently found on the buccal surface adjacent to premolars.

Answer 13

False: LINGUAL surface adjacent to premolars or molars

Question 14

Osteomas that involve the mandibular condyle will limit mouth opening and cause malocclusion. Often deviation will deflect the midline toward the _____ side.

Answer 14

unaffected

Question 15

Osteomas appear radiographically as a _____ ______ mass.

Answer 15

circumscribed, sclerotic

Question 16

What are the traits associated with Gardner Syndrome?

Answer 16

autosomal dominant inheritance= rare condition
characterized by:
-osteomas of the facial bones
-intestinal polyps
-abnormalities of teeth
-epidermoid cysts
-desmoid tumors (connective tissue)

Question 17

____% of Gardner Syndrome patients will have impacted supernumerary teeth.

Answer 17

35

Question 18

____% of Gardner Syndrome patients will have odontomas.

Answer 18

10

Question 19

What is the clinical difference between an osteoma and an epidermoid cyst?

Answer 19

osteoma = hard

epidermoid cyst = fluctuant

Question 20

What is the most significant aspect of Gardner Syndrome?

Answer 20

the development of precancerous polyps of the colon

colectomy is prophylactic

Question 21

_____% of Gardner Syndrome patients will develop adenocarcinoma of the colon by age 30.

Answer 21

50%

Question 22

How is Garnder Syndrome treated/managed?

Answer 22

• prophylactic colectomy
• cosmetic removal of cysts and osteomas
• genetic counseling
• frequent follow-up visits

Question 23

True or False: Central Giant Cell Granuloma usually affects the mandible but does not cross the midline.

Answer 23

False…CROSSES the midline

Question 24

The Giant Cell Tumor of Bone typically arises in bones and particularly in the ____ area. Pathologist feel this is histologically the same lesion as Central Giant Cell Granuloma.

Answer 24

knee

Question 25

Central Giant Cell Granuloma has a ____ predilection.

Answer 25

female

Question 26

True or False: Central Giant Cell Granulomas can become expansile.

Answer 26

True

Question 27

CGCG is seen as a proliferation of _______ tissue with numerous ________ cells scattered throughout.

Answer 27

vascular granulation tissue (extravasated RBC) | multinucleated giant cells

Question 28

Prognosis for Central Giant Cell Granuloma is ____ and treatment consists of aggressive ______.

Answer 28

good (15-20% recurrence) | curettage

Question 29

There are ____ types of hyperparathyroidism. What are they?

Answer 29

two 1. Primary 2. Secondary

Question 30

Primary Hyperparathyroidism is due to ________ and Secondary Hyperparathyroidism is due to _______.

Answer 30

Primary: parathyroid hyperplasia (inappropriate hormone secretion) Secondary: renal failure (poor calcium retention)

Question 31

What are the actions of Parathyroid Hormone?

Answer 31

- osteoclast activation - increases calcium uptake by the kidneys - increases vitamin D synthesis by the kidneys (thus promoting Calcium absorption from the gut)

Question 32

True or False: Both forms of Hyperparathyroidism result in increased serum calcium.

Answer 32

True

Question 33

What are the clinical features of hyperparathyroidism?

Answer 33

Groans, Stones, Bones, Moans, and Throans

Question 34

Hyperparathyroidism results in a radiographical _______ trabecular pattern and a loss of _____.

Answer 34

"ground glass" | lamina dura

Question 35

True or False: Long-standing renal failure can result in an enlargement of the jaws.

Answer 35

True (Renal Osteodystrophy)

Question 36

"Brown Tumors" are associated with which condition?

Answer 36

Hyperparathyroidism (extravasated erythrocytes)

Question 37

What is renal osteodystrophy?

Answer 37

unusual hyperplastic response of the bone in patients with poorly controlled secondary hyperparathyroidism - common in longterm renal dialysis patients - seen as prominent jaw enlargement

Question 38

What is the treatment for hyperparathyroidism?

Answer 38

if primary: remove the source of the hormone secretion (parathyroid) if secondary: control serum calcium via parathyroidectomy or renal transplant *fair prognosis*