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AU18: Oral Path 2 > Benign Mesenchymal Tumors > Flashcards

Benign Mesenchymal Tumors Flashcards

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1
Q

What are the possible tissues of origin for mesenchymal tumors?

A
  1. Fibrous
  2. Adipose
  3. Nerve
  4. Blood
  5. Lymph
  6. Muscle
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2
Q

What are the six benign mesenchymal tumors with fibrous origin?

A
  1. Fibroma
  2. Inflammatory fibrous hyperplasia
  3. Inflammatory papillary hyperplasia
  4. Pyogenic granuloma
  5. Peripheral giant cell granuloma
  6. Peripheral ossifying fibroma
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3
Q

T/F: A frenal tag is an example of a fibroma.

A

True

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4
Q

Where are fibromas often seen?

A

Buccal mucosa/tongue

Dome shaped with smooth/slightly papillary surface

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5
Q

What is a common lesion that involves bilateral popular lesions on the gingiva lingual to the mandibular canines?

A

Retrocuspid papilla (fibroma)

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6
Q

T/F: Recurrence of fibromas after conservative excision is rare.

A

True

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7
Q

Which fibrous tumor is often seen in the flange of ill-fitting denture?

A

Inflammatory fibrous hyperplasia

Denture epulis, epulis fissuratum, denture-induced fibrous hyperplasia

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8
Q

What is the treatment for inflammatory fibrous hyperplasia?

A

Conservative excision and remake denture

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9
Q

What are some major causes of inflammatory papillary hyperplasia?

A

Ill-fitting maxillary denture, poor denture hygiene, wearing denture 24/7

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10
Q

Numerous asymptomatic red papules are seen in the palate of a denture patient. The patient claims they have been leaving their denture in overnight. Diagnosis?

A

Inflammatory papillary hyperplasia

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11
Q

What are some histopathological features of inflammatory papillary hyperplasia?

A

Papillary surface with edema

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12
Q

T/F: Candida is common on top of inflammatory papillary hyperplasia.

A

True

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13
Q

Which reactive tumor of fibrous origin will often be seen in pregnant women as a response to local irritation/trauma?

A

Pyogenic granuloma

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14
Q

T/F: Pyogenic granuloma is due to an infection.

A

FALSE

Due to trauma. Not a true granuloma

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15
Q

T/F: Pyogenic granulomas grow slowly.

A

False

Rapid growth, painless, red, often ulcerated

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16
Q

What is the most common intraoral site for a pyogenic granuloma?

A

Gingiva

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17
Q

What are the three possible lesions that can grow out of a socket?

A
  1. Epulis granulomatosa
  2. Lymphoma
  3. Metastatic disease
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18
Q

What looks very similar to a pyogenic granuloma but is seen in an extraction socket?

A

Epulis granulomatosa

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19
Q

What type of tissue is seen in pyogenic granuloma?

A

Vascular granulation tissue

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20
Q

What are the clinical features of peripheral giant cell granuloma?

A

Painless, dusky purple-red

Only found on gingiva of alveolar ridge

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21
Q

Radiographic cupping of the underlying bone is seen in which benign tumor of fibrous origin?

A

Peripheral giant cell granuloma

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22
Q

What are the clinical features of a peripheral ossifying fibroma?

A

Painless, firm, and pink

Found only on gingiva

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23
Q

T/F: Variable amounts of calcification will be seen in peripheral giant cell fibromas.

A

False

Peripheral ossifying fibroma

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24
Q

What are the three possible fibrous tumors that will be seen on the gums?

A

3 P’s

  1. Pyogenic granuloma - pregnant
  2. Peripheral giant cell granuloma - purple-red
  3. Peripheral ossifying fibroma - pink, calcifications
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25
A __________ is a slow-growing, non-tender tumor often seen fat tissue of adult patients.
Lipoma
26
T/F: Lipomas will be firm to palpation.
False Soft, doughy
27
T/F: Lipomas often recur and can turn malignant.
False
28
What are the five benign mesenchymal tumors of nerve tissue?
1. Traumatic neuroma 2. Neurilemoma (schwannoma) 3. Neurofibroma 4. Melanotic neuroectodermal tumor of infancy 5. Granular cell tumor
29
T/F: A traumatic neuroma is a true neoplasm.
False It is a reaction to the sectioning of a nerve
30
T/F: Most oral traumatic neuromas are painful.
False 25-30% are painful
31
Where are common oral sites for traumatic neuromas?
Tongue and buccal vestibule (esp mental foramen area)
32
What is a neurilemoma?
Benign tumor of Schwann cell origin
33
What are the most common areas for neurilemomas in the mouth?
Lips, tongue, buccal mucosa
34
T/F: Neurilemoma can occur centrally within the bone.
True
35
What type of tumor can cause radiographic ballooning of the inferior alveolar canal in a unilocular or multilocular pattern?
Neurilemoma or neurofibroma
36
Neurilemoma can present with two types of tissues histopathologically. What are those tissues?
Antoni A - Palisaded nuclei around verocay bodies Antoni B - disorganized myxoid
37
T/F: The majority of neurofibromas are associated with neurofibromas.
False 90% solitary 10% multiple with neurofibromatosis
38
T/F: Schwannomas are unencapsulated.
False Neurofibromas are unencapsulated
39
What is the most common location for a neurofibroma?
Skin
40
What is a histopathological marker of neurofibroma?
Mast cells with S-100 protein
41
T/F: Nerofibromas are encapsulated.
False Demarcated but not encapsulated
42
What are the three different types of Neurofibromatosis?
NF1 - mainly neurofibromas (Von Recklinghausen) NF2 - mainly schwannomas Schwannomatosis - mainly schwannomas
43
T/F: The majority of patients with NF1 will have oral findings.
True (70-90%) Neurofibromas on tongue, gingiva, bone
44
T/F: Lisch nodules in the eyes are often seen in NF1 patients.
True
45
T/F: Cafe-au-lait spots are diagnostic of NF1.
True Must be more than 5mm in children (15mm in adults) and there must be six or more. This combined with any other criteria (including genetics) will be diagnostic
46
What is a plexiform neurofibroma?
Massive pendulous lesion associated with NF1 Feels like bag of worms
47
T/F: Freckling in armpits (axial) and groin can be diagnostic of NF1.
True
48
What is the prognosis of NF1?
Fair/guarded Can turn malignant
49
What is the tissue origin for melanotic neuroectodermal tumor of infancy (MNTI)?
Neural crest
50
What are the clinical features of melanotic neuroectodermal tumor of infancy?
Brown/black lesion in the anterior maxilla Patients less than 1 year old
51
Which lesion shows radiographically as a radiolucency with maxillary incisor pushed labially appearing as a tooth floating in space?
Melanotic neuroectodermal tumor of infancy
52
T/F: Melanotic neuroectodermal tumor of infancy is always benign.
False Can be malignant
53
T/F: 40% of granular cell tumors occur in the tongue.
True
54
Which lesion has an undetermined histogenesis and is found at birth on maxillary ridge in mostly females?
Congenital epulis
55
What is the most common tumor of childhood?
Hemangioma (blood)
56
T/F: Most hemangiomas are recognized at birth.
False Most seen by 8 weeks
57
What is the most common intraoral site for hemangioma?
tongue
58
T/F: The majority of hemangiomas resolve on their own.
True 50% by age 5, 90% by age 9
59
How long should you wait until treating a hemangioma?
Until child is 6 years old Unless life threatening or impairing vision
60
T/F: A vascular malformation is a structural anomaly of blood vessels.
True Normally endothelial cell turnover
61
What are the clinical features of a vascular malformation?
Port wine stain (capillaries), venous malformation (blue), arteriovenous malformation (bruit, thrill)
62
T/F: Vascular malformations grow proportionally with patient.
True
63
What is diascopy?
Press on the lesion with glass slide - lesion will blanch as blood is pressed into other tissues
64
T/F: If a lesion blanches with diascopy it is a vascular malformation.
False Other lesions will blanch as well
65
What are some oral considerations with port wine stain?
1. Hemorrhage may be encountered upon flossing and prophy | 2. Lasers can help remove hyperplastic lesions
66
T/F: Encephalotrigeminal angiomatosis is an inherited condition.
False Congenital vascular malformation involving CN V Can cause seizures, IQ disability, migraines, stroke-like episodes
67
Which divisions of CN V are often affected in people with Encephalotrigeminal angiomatosis?
Often in V1, can also extend into V2 or V3 If port wine stain involves entire V1, patient at high risk for neurologic and ocular involvement

AU18: Oral Path 2 (18 decks)

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