Odontogenic Cysts and Tumors

Question 1

the most common developmental odontogenic cyst; originates secondary to the separation of the follicle from the crown of an unerupted tooth; enlargement occurs secondary to increased osmotic pressure within the lumen of the cyst

Answer 1

dentigerous cyst

Question 2

M>F; 2nd and 3rd decades; mandibular 3rd molars most common, followed by maxillary canines; typically asymptomatic or a painless expansion; unilocular radiolucency; affected tooth may by displaced; may see root resorption of adjacent teeth

Answer 2

dentigerous cyst

Question 3

soft tissue counterpart to the dentigerous cyst; occurs within the soft tissue overlying the alveolar bone

Answer 3

eruption cyst

Question 4

under 10 years; typically involves mandibular molars; soft, translucent swelling of the gingival mucosa overlying an unerupted tooth

Answer 4

eruption cyst

Question 5

traditionally, defined as a cyst that develops in place of a missing tooth; most are histologically diagnosed as odontogenic keratocyst

Answer 5

primordial cyst

Question 6

distinct odontogenic cyst with specific histologic features and clinical behavior; arises from cell rests of the dental lamina; also associated with nevoid basal cell carcinoma syndrome

Answer 6

odontogenic keratocyst

Question 7

M>F; 10-40 years; mandible>Maxilla; rarely cause expansion; unilocular to multilocular radiolucency

Answer 7

odontogenic keratocyst

Question 8

not necessarily a clinical type of cyst, but an odontogenic cyst that microscopically has an orthokeratinized lining; markedly different clinical behavior from the odontogenic keratocyst

Answer 8

orthokeratinized odontogenic cyst

Question 9

nonspecific; M>F; young adults; most involve the mandibular third molars; stratified squamous epithelium that exhibits a prominent layer of orthokeratin

Answer 9

orthokeratinized odontogenic cyst

Question 10

autosomal dominant syndrome secondary to mutations in the patched (PTCH) tumor suppressor gene; high penetrance and variable expressivity; features multiple basal cell carcinomas of skin, odontogenic keratocysts, rib and vertebral anomalies, and intracranial calcifications

Answer 10

nevoid basal cell carcinoma syndrome (gorlin syndrome)

Question 11

frontal and temporoparietal bossing; ocular hypertelorism; multiple and early basal cell carcinomas; palmar/plantar pitting; bifid ribs and other skeletal anomalies; calcified falx cerebri; multiple odontogenic keratocysts

Answer 11

nevoid basal cell carcinoma syndrome

Question 12

superficial, keratin-filled cysts on the alveolar mucosa; arise from remnants of the dental lamina; similar in appearance (although not location) to Epstein’s pearls and Bohn’s nodules

Answer 12

gingival cyst of the newborn

Question 13

maxilla>mandible; multiple small papules on the alveolar processes of neonates

Answer 13

gingival cyst of the newborn

Question 14

soft tissue counterpart of the lateral periodontal cyst; derived from rests of the dental lamina; 5th-6th decade; mandibular canine-premolar area; blue to blue-gray dome-shaped swelling

Answer 14

gingival cyst of the adult

Question 15

Developmental (not inflammtory) cysts that typically occurs along the lateral root surface; probably arises from rests of the dental lamina

Answer 15

lateral periodontal cyst

Question 16

M>F; over age 30; mandibular canine-premolar area; well circumscribed radiolucency lateral to the root of a vital tooth (multilocular=botyroid)

Answer 16

lateral periodontal cyst

Question 17

uncommon cyst, sometimes associated with other odontogenic tumors; if no cystic component is present, epithelial odontogenic ghost cell tumor or deninogenic ghost cell tumor is more appropriate

Answer 17

calcifying odontogenic cyst

Question 18

avg. age 33; maxilla=mandible, often involving the maxillary incisor-canine region; may be peripheral; unilocular radiolucency, often with radiopaque structures within the lesion; most lesions are 2-4 cm; may see root resorption or divergence

Answer 18

calcifying odontogenic cyst

Question 19

rare odontogenic cyst that shows features of glandular differentiation; also referred to as sialo-odontogenic cyst; the pathogenesis of this lesion is unknown; adults, mandible; strong predilection for the anterior portions of the jaws; may cross the midline

Answer 19

glandular odontogenic cyst

Question 20

larger lesions capable of bony expansion; well-defined unilocular or multilocular radiolucency with a sclerotic rim; “hobnail” appearance to the luminal epithelial cells

Answer 20

glandular odontogenic cyst

Question 21

may arise de novo or from malignant transformation of a pre-existing cyst or neoplasm; must rule out the possibility of metastatic carcinoma

Answer 21

carcinoma arising in odontogenic cysts

Question 22

M>F, older patients; pain, swelling, parasthesia; irregular, ragged radiolucency

Answer 22

carcinoma arising in odontogenic cysts

Question 23

the most common of the odontogenic epithelial neoplasms; arises from odontogenic epithelium

Answer 23

ameloblastoma

Question 24

M=F, avg, age 34; asymptomatic swelling and expansion; posterior mandible; multilocular radiolucency, often associated with an unerupted tooth; resorption of roots is common

Answer 24

conventional ameloblastoma

Question 25

ameloblastoma _ variant: predilection for anterior regions of jaws; radiographic resemblance to fribro-osseous lesions

Answer 25

desmoplastic

Question 26

_ pattern of ameloblastoma: islands of epithelium resembling the enamel organ with peripheral palisading and reverse polarity; central area resembling stellate reticulum

Answer 26

follicular

Question 27

_ pattern of ameloblastoma: anastomosing cords or sheets of cells; peripheral palisading and reverse polarity

Answer 27

plexiform

Question 28

_ pattern of ameloblastoma: squamous metaplasia within the tumor islands; keratin formation with occasional keratin pearls

Answer 28

acanthomatous

Question 29

_ pattern of ameloblastoma: cells within the islands are characterized by a granular cytoplasm

Answer 29

granular cell

Question 30

_ pattern of ameloblastoma: small islands and cords of odontogenic epithelium; dense fibrous stroma

Answer 30

desmoplastic

Question 31

_ pattern of ameloblastoma: nests of basaloid cells; peripheral islands more cuboidal than columnar

Answer 31

basal cell

Question 32

controversy regarding its definition; some feel that the lesion must be unilocular; others believe that multilocular is acceptable if the internal aspect is cystic; 10-15% of intraosseous ameloblastomas; previously thought less aggressive lesion with significantly lower recurrence rate, but this has recently been disputed

Answer 32

unicystic ameloblastoma

Question 33

younger patients; mandible, usually posterior; asymptomatic or painless swelling; circumscribed radiolucency

Answer 33

unicystic ameloblastoma

Question 34

uncommon variant; probably arises from submucosal rests of odontogenic epithelium or from the basal layer of the surface epithelium

Answer 34

peripheral ameloblastoma

Question 35

middle aged patients; painless gingival swelling; posterior mandible; may superficially erode bone, but overall no radiographic evidence of intraosseous lesion

Answer 35

peripheral ameloblastoma

Question 36

cytologically malignant ameloblastoma

Answer 36

ameloblastic carcinoma

Question 37

cytologically benign lesion showing metastasis

Answer 37

malignant ameloblastoma

Question 38

avg. age 30; metastatic site primarily the lungs, often after 10 years

Answer 38

malignant ameloblastoma

Question 39

sixth decade; ill-defined, destructive lucency

Answer 39

ameloblastic carcinoma

Question 40

uncommon tumor of uncertain histogenesis; thought to arise from stratum intermedium of enamel organ; other theories of histogenesis include rests of the dental lamina; posterior mandible; adults; painless, slow-growing swelling

Answer 40

calcifying epithelial odontogenic tumor

Question 41

often associated with impacted tooth; unilocular to multilocular; radiolucent, with or without "driven-snow" radiopacities; amyloid (congo red positive); Liesegang rings

Answer 41

calcifying epithelial odontogenic tumor

Question 42

benign odontogenic tumor that arises either from rests of the dental lamina of the rests of Malassez; the tumor tends to originate from within the periodontal ligament; probably diagnosed previously as a variant of ameloblastoma or even squamous cell carcinoma

Answer 42

squamous odontogenic tumor

Question 43

M=F, avg, age 38; painless or slightly painful swelling; mobility of associated teeth; triangular radiolucency; SOT-like proliferations

Answer 43

squamous odontogenic tumor

Question 44

originally included in the variants of ameloblastoma; thought derived from the enamel organ epithelium or possible remnants of the dental lamina; may produce dentinoid material, rarely enamel matrix

Answer 44

adenomatoid odontogenic tumor

Question 45

F>M; Most occur during the second decade; anterior maxilla; large lesions cause a painless expansion; circumscribed radiolucency involving the crown of an unerupted tooth; extends beyond the CEJ; may contain "snowflake" calcifications

Answer 45

adenomatoid odontogenic tumor

Question 46

thick fibrous capsule; aggregates of spindle shaped cells frequently in a whorled arrangement; variable numbers of duct-like structures; may contain small foci of calcification

Answer 46

adenomatoid odontogenic tumor

Question 47

mixed odontogenic tumor with both neoplastic epithelial and mesenchymal tissues; many of these may actually represent early developing odontomas

Answer 47

ameloblastic fibroma

Question 48

M>F, first 2 decades; posterior mandible; many associated with an unerupted tooth; unilocular or multilocular radiolucency

Answer 48

ameloblastic fibroma

Question 49

mesenchymal tissue resembling the dental papilla (pulp); odontogenic epithelium in islands or cords; epithelial portion resembles developing enamel organ

Answer 49

ameloblastic fibroma

Question 50

most common odontogenic tumor; two types: compound and complex

Answer 50

odontoma

Question 51

first 2 decades; large painless expansion; may see ghost cells

Answer 51

odontoma

Question 52

_ odontoma: posterior maxilla or mandible; calcified mass with the density of tooth structure

Answer 52

complex

Question 53

_ odontoma: anterior maxilla; multiple tooth-like structures with radiolucent rim

Answer 53

compound

Question 54

uncommon lesion with two described histologic subytpes, although this has recently been questioned; simple type and WHO type

Answer 54

odontogenic fibroma

Question 55

F>M, avg. age 40; maxilla, anterior to the first molar; expansion, loosening of teeth; unilocular to multilocular radiolucency; root resorption or divergence

Answer 55

odontogenic fibroma

Question 56

_ type of odontogenic fibroma: background of fine collagen fibrils with stellate fibroblasts; may see small foci of odontogenic epithelium

Answer 56

simple

Question 57

_ type of odontogenic fibroma: more cellular fibrous connective tissue; strands and nests of odontogenic epithelium

Answer 57

WHO

Question 58

soft tissue counterpart to the odontogenic fibroma; most similar to the WHO type

Answer 58

peripheral odontogenic fibroma

Question 59

slow growing gingival mass; may cause tooth displacement; radiograph may show areas of calcification within the soft tissue mass

Answer 59

peripheral odontogenic fibroma

Question 60

considered to be of odontogenic origin, resembling the odontogenic ectomesenchyme; histologically resembles the mesenchymal portion of a developing tooth

Answer 60

myxoma

Question 61

M=F, age 25-30; mandible>maxilla; asymptomatic expansion; "soap bubble" radiolucency

Answer 61

myxoma