Ch14 Bone Path (Part V)

Question 1

_______ are benign tumors composed of mature compact or cancellous bone.

Answer 1

Osteomas

Question 2

They may Osteomas arise in what three areas?

Answer 2

1. Surface: periosteal,peripheral, or exophytic osteomas 2. Medullary bone (endosteal or central osteomas) 3. Extraskeletal osteomas ( muscle or the dermis of the skin (osteoma cutis)

Question 3

Common palatal tori, mandibular tori, and buccal exostoses are NOT considered to be ______, although they are histopathologically identical

Answer 3

osteomas

Question 4

Osteomas: age, location

Answer 4

adults, mandibular body / condyle…LINGUAL surface adjacent to premolars and molars

Question 5

condylar hyperplasia vs condylar osteoma: osetoma is typically is ________, whereas a hyperplastic
condyle usually retains its original shape

Answer 5

lobulated

Question 6

________ osteomas are even more common than gnathic lesions.

Answer 6

Paranasal sinus

Question 7

Smaller endosteal osteomas are difficult, if not impossible, to differentiate radiographically from _______, focal chronic sclerosing osteomyelitis, or idiopathic osteosclerosis..The true nature of these osteomas can be confirmed only by documentation of ________.

Answer 7

condensing osteitis…continued growth

Question 8

________ osteomas are composed of normal-appearing, dense bone with minimal marrow

Answer 8

Compact

Question 9

________ osteomas are composed of bony trabeculae and fibrofatty marrow

Answer 9

Cancellous

Question 10

Gardner syndrome represents a variant of _________

Answer 10

familial adenomatous polyposis

Question 11

Both classical familial adenomatous polyposis and theGardner syndrome variant are HIGHLY penetrant _______ disorders caused by mutations in the _______ tumor suppressor gene on chromosome ____.

Answer 11

Autosomal Dominant….adenomatous polyposis coli (APC)…5q21

Question 12

What % of Gardner syndrome pts are new mutations?

Answer 12

30%

Question 13

Garnder syndrome generally refers to cases in which the _________ manifestations are especially prominent

Answer 13

extraintestinal

Question 14

The estimated frequency of Gardner syndrome ranges from about _________ live births.

Answer 14

1 : 8,300 to 1 : 16,000

Question 15

GARDNER Syndrom: Colorectal polyps typically develop by the _____ decade of life

Answer 15

2nd

Question 16

What are the # main maifestations (think by body system) of Gardner disease?

Answer 16

1. colorectal (GI) polyps 2. osteomas 3. dental abnormalities (odontomas, supernum, impacted teeth) 4. skin lesions (epidermoid cysts, lipomas, NFs, fibromas, Leios 5. DESMOID TUMORS 6.thyroid carcinoma 7.adrenal adenoma/carcinoma 8.hepatoblastoma 9.pancreatic adenoca 10. nasopharyengeal angiofibrom 11. brain tumos 12. congenital hypertrophy of the retinal pigment epithelium

Question 17

What are the 3 dental manifestations of Gardner Syndrome?

Answer 17

1)odontomas 2) supernumerary teeth 3) impacted teeth

Question 18

What % of pts with Gardner Syndrome develop DESOMID tumors? What gender predilection? What scenario do they typically present in?

Answer 18

12-18%…female…forms in abdominal scar status post colectomy

Question 19

What % of Gardner Syndrome (FAP) pts have congenital hypertrophy of the retinal pigment epithelium?

Answer 19

58-88%

Question 20

Without treatment, 50% of Gardner Syndrome pts will develop colorectal cancer by age ___ and 100% by age ___

Answer 20

30. fuck. 50..fuck

Question 21

_____ exhibits a unique tumor nidus with a high concentration of peripheral nerves and prostaglandins

Answer 21

osteoid osteoma

Question 22

osteoid osteoma exhibits more limited growth potential than _________

Answer 22

osteoblastoma

Question 23

Classically, the distinction depends on lesion size, with osteoid osteomas measuring less than a threshold of _____ in diameter, whereas osteoblastomas are larger.

Answer 23

1.5 cm or 2 cm

Question 24

cytogenetic studies have identified recurrent alterations on the long arm of chromosome __ in some osteoid osteomas and aggressive osteoblastomas.

Answer 24

22

Question 25

Osteoblastoma: location, age, gender

Answer 25

mandibular predilection, with most examples involving the posterior regions. Approximately 85% of gnathic osteoblastomas occur before 30 years of age, and there is a slight female predominance.

Question 26

Unlike the pain associated with ________, the pain associated with ________ usually is not relieved by NSAIDs

Answer 26

osteoid osteoma....osteoblastoma

Question 27

A small subset of osteoblastomas (aggressive osteoblas- tomas) is characterized by atypical histopathologic features and locally aggressive behavior. These tumors usually occur in patients older than ___ years.

Answer 27

30

Question 28

Osteoid osteoma patients diagnosed during the ____ and ____ decades of life (mean age ___ years)

Answer 28

2nd-3rd...25

Question 29

The most prominent clinical symptom of a ________ is pain that is most severe at night and alleviated by NSAIDs.

Answer 29

osteoid osteoma

Question 30

Differentiation between aggressive osteoblastoma and low-grade _________ may be very difficult, although infiltrative growth, marked cytologic atypia, and atypical mitotic figures favor the latter.

Answer 30

osteosarcoma

Question 31

What is the only TRUE neoplasm of cementum? What does it resemble histologically?

Answer 31

Cementoblastoma..osteoblastoma

Question 32

In particular, almost 50% of cases of cementoblastoma involve which tooth?

Answer 32

mandibular first permanent molar

Question 33

The neoplasm predominantly affects ______ patients, with about 50% arising by ___ years of age and 75% by ___ years

Answer 33

young..20..30

Question 34

Are cementoblastomas symptomatic?

Answer 34

Pain and swelling are present in approximately two-thirds of reported cases.

Question 35

Interesting...cementoblastomas are considered to have a low recurrence rate, but one extensive study showed a __% risk

Answer 35

22%

Question 36

Chondromas frequently harbor somatic mutations in the ______ gene.

Answer 36

isocitrate dehydrogenase 1 (IDH1)

Question 37

Approximately 50% of chondromas are diagnosed in the ____,___, and ____ decades of life, and there is a female predilection.

Answer 37

second, third, and fourth

Question 38

Chondroma: Most gnathic examples occur in the ______ or anterior _____ of adult patients

Answer 38

Most gnathic examples occur in the condyle or anterior maxilla of adult patients

Question 39

What are the two conditions associated with chondromas?

Answer 39

Ollier disease (sporadic chondromatosis with unilateral tendency)...Maffucci syndrome (sporadic chondromatosis with soft tissue angiomas)

Question 40

Microscopic distinction between a chondroma and a low-grade ________ of the jaws may be difficult

Answer 40

chondrosarcoma

Question 41

chondromyxoid fibroma: cytogenetic studies are limited but have detected frequent abnormalities in chromosome ___

Answer 41

6

Question 42

Among reported jaw lesions chondromyxoid fibroma, the average age at diagnosis is ___ years

Answer 42

28

Question 43

Approximately three-quarters of chondromyxoid fibromas occur in the ________.

Answer 43

mandible

Question 44

chondromyxoid fibromas: jaw tumors, the overall recurrence rate is about ___%.

Answer 44

10%

Question 45

____________ typically proceeds through three stages. In the first stage, cartilaginous or osteocartilaginous nodules develop in the synovial lining. Subsequently, these nodules begin to detach, with some lying free in the joint space and others remaining in the synovial membrane. In the final stage, the nodules are found only in the joint space

Answer 45

Synovial chondromatosis

Question 46

In synovial chondromatosis... The detached particles are called ________

Answer 46

loose bodies

Question 47

Synovial chondromatosis of the TMJ occurs over a broad age range (12 to 82 years), with a peak in the ____ and ____ decades of life...gender predilection?

Answer 47

fourth and fifth...female

Question 48

Within the TMJ, synovial chondromatosis primarily involves the ________ compartment, although involvement of the _______ compartment also is possible.

Answer 48

superior...inferior

Question 49

_________ is considered the soft tissue counterpart of soft tissue fibromatosis (desmoid tumor)

Answer 49

desmoplastic fibroma

Question 50

Most desmoplastic fibromas of bone arise in patients younger than ___ years old... mean of approximately ___ years.

Answer 50

30...14

Question 51

More than 80% of desmoplastic fibromas affect the _______—most often the _____

Answer 51

mandible..posterior body

Question 52

Although the desmoplastic fibroma is a benign tumor, it often behaves in a locally ________ fashion

Answer 52

agressive

Question 53

The recurrence rate of a desmoplastic fibroma is approximately ___% for lesions treated by curettage or enucleation, compared with about ___% for those treated by resection.

Answer 53

30% .... 5%

Question 54

It may be very difficult to distinguish desmoplastic fibroma of bone from well-differentiated ________

Answer 54

fibrosarcoma

Question 55

Osteosarcomas may be classified as _______ (arising within the medullary cavity), _______ (arising in the juxtacortical region), or, vary rarely, ________ (arising within soft tissue). The vast majority of cases are ______.

Answer 55

central...surface..extraskeletal....central