Curettage ~20% recurrance Aggressive tumors treat with: - corticosteroids - calcitonin - interferon alpha 2a

On radiograph: - ameloblastoma - KOT On histo: - brown tumor of hyperparathyroidism - cherubism

Lecture 1 - Benign Non-Odontogenic Tumors of the Jaw Flashcards by C P-J

Giant Cell Lesions

Central Giant Cell Granuloma (CGCG)
Central Giant Cell Tumor
Cherubism
Aneurysmal Bone Cyst
Brown Tumor

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Pseudocysts

Traumatic Bone Cyst (Simple Bone Cyst)

Stafne Bone Cyst

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Bony and Cartilaginous Tumors

Tori & Exostoses
Osteoma
Osteoblastoma
Osteoid Osteoma

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Randos

Central Vascular Malformation
Desmoplastic Fibroma
Langerhans Cell Histiocytosis

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Central Giant Cell Granuloma Pathology

Not actually a granuloma
Central GCG - intraosseous
Peripheral GCG - soft tissue

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CGCG Clinical Appearance

2 types - Aggressive & Non-aggressive
F>M
<30yr
70% anterior mandible

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CGCG Clinical Symptoms

Non-Aggressive:

More common
Asymptomatic
Expansion
No resorption

Aggressive:

Pain
Rapid growth
High recurrance

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CGCG Radiographic Appearance

Well defined radiolucency
Uni-locular or multi-locular
Non-corticated

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CGCG Histologic Appearance

Multi-nucleated giant cells
Ovoid-spindle mesenchymal cells
Extravasated RBCs w/ hemosiderin deposits

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CGCG Treatment

Curettage
~20% recurrance

Aggressive tumors treat with:

corticosteroids
calcitonin
interferon alpha 2a

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CGCG Ddx

On radiograph:

ameloblastoma
KOT

On histo:

brown tumor of hyperparathyroidism
cherubism

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Central Giant Cell Tumor Pathology

Benign, but more aggressive than GCG

Often in long bones

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Central Giant Cell Tumor Histologic Appearance

Hypercellular

Multi-nucleated giant cells

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Cherubism Pathology

Rare
Developmental
Autosomal Dominant heritance

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Cherubism Clinical Appearance

Age 2-5
Bilateral swelling in post. mandible
Regress in puberty

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Cherubism Radiographic Appearance

Bilateral, multi-locular lucency at angle and ramus

rare: ribs and humerus

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Cherubism Histologic Appearnce

Multi-nucleated giant cells
Vascularized connective tissue
Eosinophilic cuffing (deposited around blood vessels)

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Cherubism Treatment

Wait for regression

Sometimes surgical intervention

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Aneurysmal Bone Cyst Pathology

Not a cyst - not lined with epithelium

Blood-soaked sponge appearance

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Aneurysmal Bone Cyst Clinical Appearance

F>M
<20yr
2:1 mandible

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Aneurysmal Bone Cyst Radiographic Appearance

Expansile
Uni- or multi-locular
Tooth displacement and/or reabsorption

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Aneurysmal Bone Cyst Histologic Appearance

Blood filled cystic spaces
No epithelial lining
Walls contain multi-nucleated giant cells
Osteoid production

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Aneurysmal Bone Cyst Treatment

Excision/curettage

26% recurrance

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Brown Tumor Pathology

Can by caused by primary hyperparathyroidism

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Brown Tumor Radiographic Appearance

Mixed lucent and opaque

Brown Tumor Histologic Appearance

Multi-nucleated giant cells

Traumatic Bone Cyst Clinical Appearance

M>F 10-20 yr Unilateral Mandibular

Traumatic Bone Cyst Clinical Symptoms

Asymptomatic

Traumatic Bone Cyst Radiographic Appearance

Well-circumscribed lucency | Scalloping at roots

Traumatic Bone Cyst Histologic Appearance

No epithelial lining | Lumen is empty or filled with blood or fluid

Traumatic Bone Cyst Treatment

Evacuate contents

Stafne Bone Cyst Pathology

Concavity of cortical bone on lingual surface | Developmental defect with salivary gland

Stafne Bone Cyst Clinical Appearance

M>F | 0.3% of population

Stafne Bone Cyst Radiographic Appearance

Lucency BELOW mandibular canal b/t molars and angle Well-circumscribed Notch in inferior border of mandible Unilateral

Stafne Bone Cyst Histologic Appearance

Salivary gland tissue | Some have no tissue

Stafne Bone Cyst Treatment

None

Tori and Exostoses Pathology

Bony protruberance

Tori and Exostoses Clinical Appearance

Bilateral or midline

Tori and Exostoses Histologic Appearance

Lamellar bone (normal)

Osteoma Pathology

Benign tumor of compact bone

Osteoma Clinical Appearance

Periosteal - at surface Endosteal - within the bone Young adults

Osteoma Clinical Symptoms

Painless swelling

Osteoma Radiographic Appearance

Circumscribed | Sclerotic

Osteoma Histologic Appearance

Lamellar bone | Some marrow

Osteoma Treatment

Excision of symptomatic lesions

Gardner Syndrome

Autosomal Dominant Multiple osteomas (skull, sinus, mandible) Supernumerary teeth Skin/soft tissue epidermoid cysts Desmoid tumors Thyroid carcinoma Colonic polyps -> adenocarcinoma (prophylactic colectomy)

Osteoblastoma Pathology

Benign tumor of osteoblasts | Rare

Osteoblastoma Clinical Appearance

<30yr | Vertebrae, sacrum, calvarium, long bones, post. mandible

Osteoblastoma Clinical Symptoms

Pain (unrelieved w/ aspirin)

Osteoblastoma Radiographic Appearance

Radiolucent | patchy mineralization

Osteoblastoma Histologic Appearance

Like cementoblastoma Mineralized trabeculae rimmed by osteoblasts Loose, fibrous connective tissue Radiating spicules

Osteoblastoma Treatment

Excision

Osteoid Osteoma Clinical Appearance

<2cm | Femur, tibia, post. mandible

Osteoid Osteoma Clinical Symptoms

Nocturnal pain (relieved w/ aspirin)

Central Vascular Malformation Pathology

Benign vascular lesion

Central Vascular Malformation Clinical Symptoms

Painless Swelling

Central Vascular Malformation Radiographic Appearance

``` Lucency Radiating opacities (sun burst) ```

Central Vascular Malformation Histologic Appearance

Proliferation of capillaries Endothelial cells Contains blood

Central Vascular Malformation Treatment

Surgery +/- embolization | Sclerosing agents

Desmoplastic Fibroma Clinical Appearance

<30 yr Mandible Rare

Desmoplastic Fibroma Clinical Symptoms

Painless swelling

Desmoplastic Fibroma Radiographic Appearance

Unilocular Perforate cortex/soft tissue Root resorption

Desmoplastic Fibroma Histologic Appearance

Elongated fibroblasts | Dense collagen bands

Desmoplastic Fibroma Treatment

Resection | High recurrance

Langerhans Cell Histiocytosis Pathology

Proliferation of Langerhans cells (dendritic mononuclear cells), eos, lymph, plasma cells, giant cells

Langerhans Cell Histiocytosis Clinical Appearance

M>F <15 yr 1. Eosinophilic granuloma of bone (bone lesions) 2. Chronic disseminated histiocytosis (bone, skin, visceral) 3. Acute disseminated histiocytosis (cutaneous, visceral, marrow, infants)

Langerhans Cell Histiocytosis Radiographic Appearance

NON-corticated lucencies | Teeth "floating in air"

Langerhans Cell Histiocytosis Histologic Appearance

Large, pale, mononuclear cells Birbeck granules Eosinophils

Langerhans Cell Histiocytosis Treatment

Surgery Radiation Chemotherapy Better prognosis in older pts w/o visceral involvement.

Lecture 1 - Benign Non-Odontogenic Tumors of the Jaw Flashcards

(69 cards)