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Flashcards in Chapter 12 Deck (27):
1

What is the MOST common “tumor” of the oral cavity, reactive hyperplasia of fibrous Connective Tissue in response to local irritation or trauma (usually a bite/chewing), most common location is the buccal mucosa along the bite line, typically appears as an asymptomatic, sessile, smooth-surfaced nodule that is similar in color to the surrounding mucosa, and MUST submit excised tissue for microscopic examination? *(Similar to a neoplasm, but a neoplasm has unlimited growth potential. This entity has limited growth potential)

- Fibroma

2

What is a fibrous tumor with distinctive features; not associated with chronic irritation, typically have a papillary surface, occurs at a younger age than other fibromas, and predilection for the gingiva? What is a microscopically similar lesion of the gingiva to this entity, but it is lingual to mandibular cuspid, typically bilateral, present in up to 99% of children and is a normal anatomic variation that regresses with age?

- Giant Cell Fibroma
- Retrocuspid Papilla

3

What is a tumor-like hyperplasia of fibrous connective tissue, and that usually develops on the facial aspect of the alveolar ridge? What is the name given for this entity in association with the flange of an ill-fitting denture?

- Inflammatory Fibrous Hyperplasia (IFH)
- Epulis Fissuratum

4

What is a reactive tissue growth that develops under a denture, is usually due to an Ill-fitting denture, Poor denture hygiene and Wearing denture 24h a day. 20% of patients who continuously wear their denture have IPH, Typically occurs on the hard palate, Asymptomatic, erythematous tissue with a pebbly or papillary surface, Most patients also have a Candidal infection, For very early lesions, removal of the denture may allow healing, Condition may show improvement after anti fungal therapy, and For more advanced lesions, treatment is surgical removal?

- Inflammatory Papillary hyperplasia (IPH)

5

What is a true neoplasm exhibiting fibroblastic and histolytic differentiation and occurs most commonly on the skin?

- Fibrous Histiocytoma

6

What represents the oral counterpart of a Cutaneous Focal Mucinosis, and Results from overproduction of hyaluronic acid by fibroblasts?

- Oral focal mucinosis

7

What is NOT a true granuloma, but is a reactive lesion to local irritation or trauma (poor oral hygiene), May exhibit rapid growth, Smooth or lobulated mass that is typically pedunculate, Surface is characteristically ulcerated and lesion bleeds easily, Young lesions appear red; older lesions are more collagenized and pink and is also known as a Pregnancy tumor or Granuloma Gravidarum?

- Pyogenic Granuloma (PG)

8

What is a reactive lesion caused by local irritation or trauma, Occurs exclusively on the gingiva or edentulous alveolar ridge, Appears as an erythematous mass similar to PG, although is often more blue or purple compared to the bright red PG, May produce a “cupping” resorption of the underlying Alveolar Bone and Adjacent teeth should be scaled?

- Peripheral Giant Cell Granuloma (PGCG)

9

What occurs exclusively on the gingiva, appears as a nodular mass, usually originating from the dental papilla, average age is 15 (teenagers and young adults 10-19), 50% of cases occur in the Incisor-Cuspid region and can reoccur?

- Peripheral Ossifying Fibroma (POF)

10

What is a benign tumor of fat, is By far the MOST common Mesenchymal Neoplasm, is More common in obese patients, but the metabolism is independent of normal body fat, Appear as soft, smooth-surfaced nodular masses , Lesion may be yellow or mucosal-colored, and Float in formalin (helps with diagnosis)?

- Lipoma

11

There are two types of Neuroma? What makes them different?

- Traumatic Neuroma
o Not a true neoplasm; it is a proliferation of neural tissue after nerve injury
o Most common in mental foramen area
- Palisaded Encapsulated Neuroma (PEN)
• AKA Solitary circumscribed neuroma
• Benign neural tumor typically found on the face (90%)
• Average age is 50

12

What is a Benign neural neoplasm of Schwann cell origin, Slow-growing, encapsulated tumor which arises in association with a nerve trunk, is Typically asymptomatic, is Most common in young and middle-aged adults? This has two types of histopathologic features (Antoni A and B), what makes them different?

- Schwannoma (Neurilemoma)
- o Antoni A – Streaming fascicles of spindle-shaped Schwann cells which form a palisaded arrangement around central acellular, eosinophilic areas known as Verocay bodies
o Antoni B – Basically everything that’s not Antoni A

13

What is the MOST common type of peripheral nerve neoplasm, Can arise as solitary tumors or be a component of neurofibromatosis, Most common in young adults and present as slowly-growing, soft, painless lesions, Skin is the most common location, and the Tongue and buccal mucosa are most common intraoral sites?

- Neurofibroma

14

What is the MOST common of the 8 recognized forms of this, is an enlargement of the fungiform papilla, has intraoral neurofibromas, has enlargement of the mandibular foramen/canal, is Pathognomonic (if you have the gene you have the disease), and up to 5% have malignant peripheral nerve sheath tumors (MPNST) with an associated 5-year survival of 15%? What is another name for this? What are the 8 diagnostic criteria?

- Neurofibromatosis Type I (NF1)
- Von Recklinghausen’s disease of the skin
- 8 Diagnostic Criteria (2 are required):
o Six or more café au lait macules
o “Coast of California”
o Two or more NF or one plexiform NF
o Freckling in the axillary region (Crowe’s sign)
o Optic glioma
o Two or more iris hamartomas (Lisch nodules)
o Osseous lesion such as sphenoid dysplasia
o First-degree relative with NF1

15

When a bump is seen on the gums, what are the 4 most common diagnosis?

- 3 P's and a F
- Peripheral Giant Cell Granuloma (PGCG)
- Peripheral Ossifying Fibroma (POF)
- Pyogenic Granuloma (PG)
- Fibroma

16

What is characterized by Patients that have a marfanoid build with thin, elongated limbs; Patients also have a narrow face with characteristically thick and protuberant lips, where Bilateral neuromas of the commissural mucosa are highly characteristic, and Diagnosed between the ages of 18-25 and has a marked propensity for metastasis? What are typically the first sign of the condition? What 6 things characterize this?

- Multiple Endocrine Neoplasia, Type 2B (MEN 2B)
- Oral mucosal neuromas are typically the first sign of the condition
- o Parathyroid tumors
o Pituitary tumors
o Pancreatic tumors
o Adrenal gland tumors (pheochromocytoma)
o Thyroid tumors (medullary carcinoma)
o Mucosal neuromas with a predilection for the oral cavity

17

What is a Rare pigmented tumor, Usually occurs during the 1st year of life, has Striking predilection for anterior maxilla (61%), Rapidly expanding mass, Clinically black and/or blue, High urinary levels of vanillylmandelic acid (VMA) and Most are benign?

- Melanotic neuroectodermal tumor of infancy

18

What is a Benign soft tissue neoplasm that shows a predilection for the oral cavity, Most common site is the tongue (up to 50%), with the dorsal surface being most common site, Typically occurs around age 40; rare in kids, May be yellow or mucosal-colored, African American patients may experience multiple tumors? Significantly, these tumors exhibit significant _________ __________. What test would you use and what would it read?

- Granular Cell Tumor
- Pseudoepitheliomatous hyperplasia (PEH)
- S-100 test Positive

19

What Occurs almost exclusively on the alveolar ridges of newborns, Appears as a mucosal-colored, smooth-surfaced, polypoid mass that typically less than 2 cm , 3x more common in the maxillary ridge, Most frequently where the developing lateral incisor-canine area, 90% occur in females, No Pseudoepitheliomatous hyperplasia (PEH); and S-100 negative (different from granular cell tumor) and Surgical excision is curative, even with incomplete removal?

- Congenital Epulis

20

What is The most common tumor of infancy, More common in females (3:1, 5:1), and in whites (versus other racial groups) and Most common location is the head and neck, which accounts for 60% of all cases? What are the two types and what makes them different?

- Hemangioma
- Capillary & Cavernous
o Capillary: may not blanch clinically, usually red in color
o Cavernous: typically blanches, darker red to purple

21

What is a Rare, nonhereditary developmental condition that is Caused by the persistence of a vascular plexus around the cephalic portion of the neural tube, Has unilateral distribution along one or more segments of the trigeminal nerve, May result in mental retardation or contralateral hemiplagia (one-sided paralysis) and Intraoral involvement is common and results in hypervascular changes to the ipsilateral mucosa? These Patients are born with a dermal capillary vascular malformation known as _______ _______ ______ or ______ _______.

- Sturge-Weber Angiomatosis
- Port wine stain or Nevus flammeus

22

What is a Benign tumor of lymphatic vessels, has Marked predilection for head and neck, accounts for 50%-75% of all cases, Half of all lesions are noted at birth, 90% develop by 2 years of age, Oral lymphangiomas occur most frequently on the anterior two thirds of the tongue, where they often result in macroglossia, Clinically can look like “frog eggs” or “tapioca pudding"? What are the three types and what makes them different?

- Lymphangioma
• Types: capillary, cavernous, cystic
• Cavernous lymphangiomas are more frequently found in the mouth
• Cystic lymphangiomas (cytic hygroma) most often occur in the neck

23

What are benign tumors of smooth muscle, Most common in uterus, GI tract, skin, 75% or oral cases are a vascular variant, Typically present as an asymptomatic, slowly-growing, firm, mucosal nodule and Excision is curative?

- Leiomyoma

24

What is a Benign neoplasm of skeletal muscle, Extracardiac rhabdomyomas are very rare but have, predilection for the H&N, Adult and fetal types
o Adult:
♣ 70% in adult men
♣ Nodular mass most commonly occurring in the pharynx and floor of mouth
o Fetal:
♣ Young male patients
♣ Predilection for the face
and Excision is curative?

- Rhabdomyoma

25

What is a Malignancy of skeletal muscles, 60% of soft tissue sarcomas of childhood, 35% are found in the head and neck, Face & orbit are common locations, Presents as a painless, infiltrative mass that grows rapidly, Treatment is surgery and chemotherapy with radiation, Survival ranges from 50% to 95% depending on histologic subtype?

- Rhabdomyosarcoma

26

What is thought to be the Mechanism by which tumors can spread to the oral cavity (Metastases) from adjacent tissues? What is thought to be the Mechanism by which tumors can spread to the oral cavity (Metastases) from the lower parts of the body? What are these tumors of the oral cavity where the Gingiva is the most common site for the soft tissues (50% of all cases), then tongue (25%), Lesion appears as a nodular mass that resembles a hyperplastic growth, such as a pyogenic granuloma, Most cases represent carcinomas rather than sarcomas and Prognosis is poor?

- Lymphatics
- o Batson’s plexus: This is a valveless vertebral venous plexus that might allow retrograde spread of tumor cells & bypass the lungs.
- Metastases to the oral soft tissues

27

What are caused by HHV-8, has 4 clinical presentations: Four clinical presentations: Classic, Endemic (African), Latrogenic immunosuppression associated and AIDS related? What makes these four presentations different?

- Kaposi’s sarcoma
- • Classic type:
o 80% in older men
o Italian, Jewish, or Slavic descent
o Multiple, asymptomatic blue-purple macules on the lower extremities which grow into nodules
• Endemic (African) has 4 subtypes
o Benign nodular (similar to classic)
o Aggressive
o Florid
o Lymphadenopathic (children)
• Iatrogenic:
o Most common in organ transplant recipients
o 0.5% of renal transplant patients
- AIDS: Comes from AIDS