Exam 3 ST Masses (Developmental)

Question 1

Name the pathology:

Ectopic sebaceous glands, Multiple yellow-white
papules

Answer 1

Fordyce Granules

Question 2

Etiology of Fordyce granules.

Answer 2

Ectopic sebaceous glands

Question 3

What is the prevalence of Fordyce Granules?

Answer 3

Present in over 80% of the
pop

Question 4

How would you diagnose and tx Fordyce granules?

Answer 4

Dx - clinical presentation

Tx - NONE

Question 5

Name the pathology:

Superficial dilated tortuous veins, Weakening of blood vessel walls and loss of tone in supporting CT

Answer 5

Varix/Varicosities

Question 6

Varix/Varicosities occur in ____ of people over the age of _____.

Answer 6

2/3rds; 60

Question 7

T/F Varix are common in children

Answer 7

FALSE

Question 8

Describe clinical presentation of varix

Answer 8

Blue-purple nodules
May be solitary or multiple
Can become thrombosed (firm)

Common on ventral and lateral surfaces of the tongue
Common on lips and buccal mucosa

Question 9

What site are you likely to find varix in the oral cavity?

Answer 9

ventral and lateral surfaces of the tongue

lips and buccal mucosa

Question 10

How would you diagnose varix?

Answer 10

Usually a clinical diagnosis can be made BUT Biopsy for solitary varicosities of the lip and buccal mucosa may be indicated.

Question 11

How would you tx varix?

Answer 11

NO tx

Question 12

What are the developmental ST masses that we said did not need tx?

Answer 12

Fordyce granules

Varix/Varicosities

Lymphoepithelial cyst (unless want to remove)

Lingual thyroid - sometimes hormone therapy

Question 13

Name the pathology:

Derived from rests of dental lamina
Soft tissue counterpart to lateral periodontal cyst

Answer 13

Gingival cyst of the adult

Question 14

Where are you most likely to find gingival cyst of the adult in the oral cavity? (site)

Answer 14

Predilection for mandibular canine and premolar area
Always on facial gingiva/alveolar mucosa

Question 15

Describe the clinical presentation of Gingival cyst of the adult.

Answer 15

Painless, domelike swelling
Bluish-gray color
May cause “cupping out” of alveolar bone

Question 16

How would you diagnose and tx Gingival cyst of the adult?

Answer 16

Biopsy and excisional biopsy

Question 17

What does Gingival cyst of the adult arise from?

Answer 17

Rests of dental lamina

Question 18

Name the pathology:

Keratin filled cyst arising from hair follicle

Answer 18

Epidermoid cyst

Question 19

Epidermoid cyst are unusual to have before ______.

Answer 19

Puberty

Question 20

Site to find Epidermoid cyst

Answer 20

Common in acne prone areas of head, neck, and back
Not found intraorally

Question 21

What developmental ST mass is NOT found in the oral cavity?

Answer 21

Epidermoid cyst

Question 22

Describe clinical presentation of Epidermoid cyst

Answer 22

Nodular, fluctuant subcutaneous lesion
White or yellow (red if inflamed)

Question 23

How to tx epidermoid cyst?

Answer 23

Excisional biopsy

Question 24

How to diagnose epidermoid cyst?

Answer 24

Biopsy

Question 25

Name the pathology: Occlusion and dilation of a crypt of lymphoid tissue

Answer 25

Lymphoepithelial cyst

Question 26

Demographic to find Lymphoepithelial cyst

Answer 26

Young adults

Question 27

Site to find Lymphoepithelial cyst (think about order)

Answer 27

Floor of mouth Ventral tongue Posterior lat border of tongue Soft palate Palatine tonsil

Question 28

Describe the clinical presentation of Lymphoepithelial cyst

Answer 28

Small submucosal mass Firm or soft to palpation Typically white or yellow

Question 29

How to diagnose Lymphoepithelial cyst

Answer 29

Clinical diagnosis Biopsy

Question 30

How to treat Lymphoepithelial cyst

Answer 30

Excisional biopsy or NO tx

Question 31

Name the pathology: Ectopic thyroid tissue Failure of thyroid bud to descend normally into neck from foramen cecum

Answer 31

Lingual Thyroid

Question 32

Lingual Thyroid is more common in males or females?

Answer 32

Females

Question 33

Name the pathology: Nodular mass on the posterior dorsal tongue May be accompanied by dysphagia, dysphonia, and dyspnea

Answer 33

Lingual thyroid

Question 34

How to diagnose lingual thyroid?

Answer 34

Thyroid scan Avoid biopsy (risk of hemorrhage and may be pt only functioning thyroid tissue)

Question 35

How to tx lingual thyroid?

Answer 35

Follow-up; hormone therapy if necessary

Question 36

T/F 72% of pt with lingual thyroid are accompanied with hyperthyroidism.

Answer 36

FALSE HYPOthyroidism

Question 37

MEN2B is a _____ gene mutation.

Answer 37

RET

Question 38

Neurofibromatosis type I is a _______ gene mutation.

Answer 38

NF1

Question 39

T/F Both MEN2B and NF1 have autosomal dominant inheritance pattern.

Answer 39

True

Question 40

Name the pathology: "RET gene mutation Autosomal dominant inheritance pattern "

Answer 40

Multiple Endocrin Neoplasia Type 2B (MEN2B)

Question 41

Name the pathology: "NF1 gene mutation Autosomal dominant inheritance pattern"

Answer 41

Neurofibromatosis type I (NF1)

Question 42

What are the 3 clinical presentations of MEN2B?

Answer 42

1. Mucosal Neuromas (often first sign) 2. Medullary thyroid carcinoma 3. Pheochromocytoma

Question 43

T/F Mucosal neuromas are soft, painful papules or nodules that tend to involve oral cavity.

Answer 43

False painless

Question 44

T/F Mucosal neuromas have NO potential of malignancy

Answer 44

TRUE

Question 45

Why do you often do a preventative thyroidectomy in a pt with MEN2B?

Answer 45

Because of the increased risk of medullary thyroid carcinoma

Question 46

What tumors do you have to worry about forming with MEN2B?

Answer 46

Medullary thyroid carcinoma Pheochromocytoma (adrenal gland tumor) - impending sense of doom extremely high BP

Question 47

How to diagnose MEN2B?

Answer 47

Biopsy of oral lesions Genetic testing

Question 48

How to tx MEN2B?

Answer 48

Preventative thyroidectomy Observation for development of pheochromocytoma

Question 49

What clinical presentation are present with NF1? (4 things)

Answer 49

1. Multiple neurofibromas of skin and mucosa with Potential to become malignant peripheral nerve sheath tumor 2. Cafe au lait macules (light brown skin pigmentation) 3. Axillary and inguinal freckling 4. Lisch Nodules (pigmentation defects of iris)

Question 50

Multiple neurofibromas of SKIN and MUCOSA have the potential to become malignant _________ ________ ____________ _________.

Answer 50

peripheral nerve sheath tumor

Question 51

How to diagnose NF1?

Answer 51

Biopsy Genetic testing

Question 52

How to tx NF1?

Answer 52

Cosmetic excision of neurofibroma (if possible) Monitoring for signs of malignant peripheral nerve sheath tumor

Question 53

Fordyce Granules Ectopic_______ glands, Multiple yellow-white ______

Answer 53

sebaceous; papules