Neoplasia Information Flashcards by Spencer Dutton

Criteria for epithelial dysplasia? (3 pts)

1- dyskeratosis (premature keratosis)
2- keratin in epithelial layer
3- hyperchromatism (increased staining)

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Is erythroplakia common?

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What is eryhtroplakia?

red patches, without increase in vascularity

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Results of diascopy test on erythroplakia?

Negative. No blanching

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What is critical with regard to biopsy for speckled leukoplakia/speckled erythroplakia?

need to biopsy multiple locations

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Where does basal cell carcinoma occur?

NOT ORAL CAVITY. occurs on skin/lip

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What is a common location of basal cell carcinoma?

mid-face

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3 characteristics of basal cell carcinoma

1- slow growing
2- non-healing ulcer
3- raised pearly white border

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What is the most and second most common cancers of the skin?

1 - basal cell carcinoma

2- squamous cell carcinoma

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Prognosis of basal cell carcinoma?

VERY GOOD. very rarely does it metastasize (unles you leave it for a long ass time)

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What is most common oral cancer of oral cavity?

squamous cell carcinoma

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common location of squamous cell carcinoma of lip vermillion?

Lower lip vermillion

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Treatment for squamous cell carcinoma of lip vermillion?

Biopsy first (including border), and lip shaving

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what is the percent chance that erythroplakia is pre-cancerous?

90%

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What does T,M,N stand for in staging of OSCC?

T - tumor size
M - M0 (not metastasized), M1 (has metastasized)
N - Lymph node involvement

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2 characteristics of verrucous carcinoma (ackermans tumor, snuff dipper’s cancer)

1- grows laterally over vertically/invasively

2- wart-like surface (roughened)

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A,B,C,D,E clinical features of melanoma

A - asymmetry
B - border irregularity
C - Color variation
D - Diameter greater than 6mm
E - Evolving (growing)

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What is 3rd most common skin cancer?

Melanoma

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Most deadly skin cancer?

Melanoma

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What does melanoma arise from?

de novo(out of nowhere), or from acquired melanocytic nevus

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2 Most common locations of oral melanoma?

hard palate mucosa, gingiva

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Most common location of a fibroma?

buccal mucosa (by bite line, probably consequence of trauma from biting)

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What may be different with a fibroma for a white/black patient?

Black patient may gray pigmentation

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2 characteristics of fibroma

1- smooth surface

2- firm

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are fibromas common?

Yes

Are lipomas common on skin/oral cavity?

Common on skin, not in oral cavity

How can we differentiate lipoma from fibroma?

Lipoma is softer and may have yellowish tinge

Most common location of oral lipomas?

buccal mucosa and buccal vestibule. but can be on tongue lips, floor of mouth

What would results be on diascopy test for a hemangioma?

positive (color will move with glass slide pressure)

2 characteristics of hemangiomas?

smooth surface | blue-ish/reddish tinge

Are central hemangiomas common?

No very rare

What is a central hemangioma?

hemangioma occuring within bone

If you push on a loose tooth and it bleeds, what do you do?

DO NOT EXTRACT. could be central hemangioma

Where exactly do lymphangiomas occur?

Lymphatic channels, NOT LYMPHOCYTES

What is a cystic hygroma?

type of lymphangioma that occurs in the head/neck

What does a hemangioma affect?

vascular channels: arteries and veins

How do we treat osteomas?

lay back flap and drill/chisel excess bone

What are the 4 features of Gardner Syndrome?

1. multiple osteomas 2. multiple epidermoid cysts (skin cysts) 3. supernumerary teeth 4. Intestinal polyps (often become malignant)

What is 2 features of fibrosarcoma?

1. Increasing in size | 2. fleshy lesion

Are Liposarcomas common in oral cavity?

What is Angiosarcoma?

Malignant neoplasm of blood vessels

What is the most common malignant neoplasm of connective tissue in the oral cavity?

osteosarcoma

What cell specifically becomes malignant with osteosarcoma?

osteoblasts

What are 5 features of osteosarcoma in a radiograph?

1. symmetrical widening of PDL 2. loss of lamina dura 3. change in trabecular pattern 4. malignant osteoblasts still producing bone but invading elsewhere 5. sun burst/sun ray effect (bone projecting into soft tissue

2 features of chondrosarcoma?

1. symmetrical widening of PDL | 2. abnormal trabecular pattern

what is a leiomyoma?

benign neoplasm of smooth muscle

2 characteristics of leiomyoma?

1. slow-growing | 2. firm

4 most common locations of leiomyoma?

1. lips 2. tongue 3. palate 4. cheek

most common location of rhabdomyomas? (3 locations)

1. floor of mouth 2. soft palate 3. base of tongue

Where do have of all oral leiomyosarcomas occur in the oral cavity?

jawbones

2 characteristics of a leiomyosarcoma?

1. fleshy | 2. growing elevated lesion

where is the most frequent location of rhabdomyosarcoma?

Palate

2 characteristics of rhabdomyosarcoma?

1. grows fast | 2. painless (usually)

3 symptoms of multiple endocrine neoplasia (MEN) type 2B

1. medullary thyroid carcinoma 2. adrenal pheochromocytomas (medullary part) 3. oral mucosal neuromas

What disease can result in 100's of neurofibromas and pigmentation of the skin?

Multiple neurofibromatosis type 1 (von recklinghausen disease of skin)

what malignant transformation can occur with multiple neurofibromatosis type 1?

neurofibrosarcoma

whats another name for a schwannoma?

Neurilemoma

What is the most common location for a schwannoma?

Tongue

1 characteristic of schwannoma?

slow growing

Most common locations of ORAL neurogenic sarcoma (neurosarcoma)

mandible, lips, and buccal mucosa

neurosarcoma/neurogenic sarcoma of the madible may present what radiographic features?

widening of mandibular canal or mental foramen (with or without destruction of surrounding bone

What is the common location of a granular cell tumor?

tongue

What are the 4 histologic features of a granular cell tumor?

1. pseudoepitheliomatous hyperplasia 2. overproliferation of epithelial cells 3. elongation of rete bridges 4. large cells within granular layer

What is the almost exclusive location of the congenital epulis of the newborn?

alveolar ridges

What does the peripheral ossifying fibroma come from? (it is often mistaken for this)

pyogenic granuloma

Where can pyogenic granulomas occur?

Anywhere in oral cavity

Where do peripheral ossifying fibromas occur?

almost exclusively to gingiva

Where does the peripheral giant cell granuloma almost exlusively occur?

on gingiva edentulous alveolar ridge

What feature of the peripheral giant cell granuloma OFTEN makes it distinguishable from a pyogenic granuloma?

it is more blue/purple

What 3 reactive localized gingival enalrgement lesions are always included together in a DDX?

pyogenic granuloma, peripheral ossifying fibroma, and peripheral giant cell granuloma

What type of lesion is a squamous papilloma?