mixed radiolucent/opaque lesions Flashcards
(40 cards)
Ossifying fibroma
B/M?
o Consists of?
o growth? symptoms? expansion?
o Facial app?
o ages?
o gender?
oJuvenile ossifying fibroma?
Benign odontogenic tumor
o Consists of highly cellular, fibrous tissue that contains varying amounts of mineralized tissue (abnormal bone and/or cementum)
o Slow growing, asymptomatic (at the time of discovery) and expansile.
o Facial asymmetry (occasionally)
o Young adults (20-30 years of age)
o Females> males
oJuvenile ossifying fibroma is a very aggressive form of ossifying fibroma that occurs in the first 2 decades of life (more expansile and rapid growth)
ossifying fibroma
Ossifying fibroma Imaging features:
oMost commonly in the?
o If in the mandible:
o If in the maxilla:
oPeriphery:
oMost commonly in the mandible.
o If in the mandible: Inferior to the premolars and molars
and superior to the inferior alveolar canal.
o If in the maxilla: it occurs most often in the canine
fossa and zygomatic process of the maxilla area.
oPeriphery: Well-defined and the cortical borders may
appear thickened.
ossifying fibroma
Ossifying fibroma Effects on the surrounding tissues:
o Concentric growth (equal in all directions)
o Thinning and displacement of the bone cortices (remaining intact)
o Teeth displacement (missing lamina dura)
o Displacement of the IAC and teeth. Root resorption may occur
oss fibroma internal pattern
The internal pattern may be very similar to fibrous dysplasia. One distinguishing feature that may be present is a soft tissue capsule at the periphery not seen in fibrous dysplasia
oss fibroma
Ossifying fibroma
oInternal structure:
oInternal structure: Mixed radiopaque-radiolucent. Could be totally radiolucent. The amount of mineralized tissue will determine the amount of radiopacities
oss fibroma tx
oEnucleation or resection
oUnlikely recurrence
juvenile oss fibroma
oss fibroma
Garre’s osteomyelitis
o def?
o demo?
oMost common site in the head and neck?
oMay cause?
o Atypical chronic osteomyelitis with prominent periosteal reaction. Hypothesis: Initiated by bacterial infection but after time the infection resolves but the bone inflammation persists (usually no bacteria detected at the time of the culture)
o Affects children, mean age of 12 years (below 30). Slight male predominance
oMost common site in the head and neck is the mandible
oMay cause facial asymmetry and pain is uncommon. Fever, lymphadenopathy, and leukocytosis may be present
garres osteomyelitis
garres osteomyelitis
garres osteomyelitis
in a teenager, likely dx?
garres
Osteosarcoma
o def?
o demo?
o s/s?
o more cmmon arch/area?
o broders/cortex? pdl?
oInternal structure:
oMalignant neoplasm of osteoblasts in which osteoid is produced by the malignant cells. Rare on the jaws (7% of all osteosarcomas)
oMale : female 2:1. Peak in the fourth decade.
o Rapid enlarging swelling, pain, tenderness, erythema of the overlying mucosa, ulceration,
loose teeth, non healing extraction site, epistaxis, hemorrhage, nasal obstruction, exophthalmos, trismus, parethesia and blindness.
o Mandible more affected than maxilla, mostly posterior areas.
o Poorly defined borders and no cortication. Cortical destruction may be seen (soft tissue
invasion). We may see irregular widening of the PDL.
o Internal structure: radiolucent, radiopaque, mixed. Will depend on the ability to produce bone.
unique radio finding of osteosarcomas?
sunray periosteal reaction
osteosarcoma
osteosarcoma management
Surgery, radiation therapy, and chemotherapy alone or in combination
osteosarcoma
Chondrosarcoma
o def?
o age/sex?
o mnan/max?
oThe tumors are covered with?
oPatient may have a?
o If occurring in the TMJ:
o Chondrosarcoma is a malignant tumor of mesenchymal origin that produces cartilage. Rare on the jaws (10% of all chondrosarcomas)
o Occur in any age (mean age, 47 years). Males and females affected equally.
oAffects maxilla and mandible equally (in areas where cartilage may be present)
oThe tumors are covered with normal overlying skin or mucosa unless secondarily ulcerated.
oPatient may have a painless hard mass of relatively long duration (slow growing)= May be well defined and corticated at times (this may be misleading to think it may be a benign entity)
o If occurring in the TMJ: pain, trismus and/or abnormal joint function
chondrosarcoma
chondrosarcoma
