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Oral Medicine > Odontogenic Cysts and Tumors > Flashcards

Odontogenic Cysts and Tumors Flashcards

1
Q

what is the definiteion of an odontogenic cyst?

A

a pathologic cavity lined by odontogenic epithelium and filled with fluid or semisolid fluid

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2
Q

which odontogenic tumors are odontogenic epithelial in origin?

A
  • adenomatoid odontogenic tumor (AOT)
  • calcifying epithelial odontogenic tumor (CEOT)
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3
Q

what are 3 mixed odontogenic tumors?

A
  • ameloblastic fibroma
  • ameloblastic fibro-odontoma
  • odontoma
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4
Q

___ is a cyst that originates by separation of the follicle from around the crown of an unerupted tooth

A

dentigerous cyst

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5
Q

what is the most common developmental cyst?

A

dentigerous cyst

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6
Q

a dentigerous cyst encloses the ___ of an unerupted tooth and is attached at the ___

A
  • crown
  • CEJ
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7
Q
A

dentigerous cyst

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8
Q
A

dentigerous cyst

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9
Q
A

dentigerous cyst

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10
Q
A

dentigerous cyst

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11
Q

dentigerous cysts involve which teeth most commonly?

A

man 3rds > max 3rds > max canines > man canines

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12
Q

do dentigerous cysts cause expansion?

A

not usually, unless they are left untreated long enough

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13
Q

the white stuff is keratin

A

can be either an orthokeratinized odontogenic cyst or odontogenic keratocyst

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14
Q

what are the two most important things to know about odontogenic keratocysts?

A
  • 30% recurrence rate
  • assocaited with Gorlin’s syndrome
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15
Q

Gorlin’s syndrome is also called ___

A

nevoid basal cell carcinoma syndrome

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16
Q

what chromosome and gene is associated with gorlin’s syndrome?

A

chromosome 9, PTCH gene

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17
Q
A

odontogenic keratocyst

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18
Q
A

odontogenic keratocyst

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19
Q
A

odontogenic keratocyst

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20
Q
A
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21
Q
A
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22
Q

describe the histological appearance of an odontogenic keratocyst

A
  • thin, friable wall
  • epithelial lining is a uniform 6-8 cell layers thick
  • basal cell layer shows palisading and is hyperchromatic
  • epithelium is surfaced by wavy parakeratin
  • may have small satellite cysts away from the primary lesion (“daughter cysts”)
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23
Q

what is one of the main reasons the recurrence rate of OKCs is so high?

A

daughter cysts

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24
Q
A

OKC

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25
Q
A

OKC

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26
Q
A

OKC

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27
Q

___ is an odontogenic cyst with orthokeratinized lining and no basal palisading

A

orthokeratinized odontogenic cyst

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28
Q

what location are OOCs most common?

A

posterior mandible

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29
Q

what is the radiographic presentation of an OOC?

A
  • typically unilocular
  • usually appears as a dentigerous cyst around a 3rd molar
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30
Q

what is the recurrence rate of an OOC?

A

2% after enucleation with curettage

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31
Q
A

technically this is an OOC (presents as a dentigerous cyst around a 3rd molar), but you’d need a biopsy to confirm

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32
Q

which one is an OOC and which is the OKC?

A

OOC on the left, OKC on the right

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33
Q

empty cavity

A

traumatic bone cyst

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34
Q
A

traumatic bone cyst

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35
Q

traumatic bone cyst is also called a ___

A

simple bone cyst

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36
Q

___ is a benign, empty, or fluid filled cavity within bone

A

traumatic bone cyst

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37
Q

do traumatic bone cysts have an epithelial lining?

A

no, so “cyst” is actually a misnomer

38
Q

what is the most widely accepted etiological theory for tramatic bone cysts?

A
  • trauma-hemorrhage theory
  • trauma to the bone is insufficient to cause a fracture so it results in an intraosseous hematoma
  • if the hematoma does not undergo organization and repair, it may liquefy and result in a defect
39
Q

what age range are traumatic bone cysts typically found? what is the most common location?

A

10-20, almost exclusively in the mandible

40
Q

how do traumatic bone cysts present clinically?

A

asymptomatic, 20% have a swelling

41
Q

asymptomatic, empty cavity

A

traumatic bone cyst

42
Q

asymptomatic, empty cavity

A

traumatic bone cyst

43
Q
A

calcifying odontogenic cyst

44
Q

ghost cells

A

calcifying odontogenic cyst

45
Q

what is another name for a calcifying odontogenic cyst?

A

gorlin cyst

46
Q

what is the most common location for calcifying odontogenic cysts?

A

65% are found in the incisor/canine area

mx=md

47
Q

20% of calcifying odontogenic cysts are associated with ___

A

odontomas

48
Q

what are the radiographic features of calcifying odontogenic cysts?

A
  • unilocular, well-defined RL
  • RO structures are seen within the RL in 50%
  • 1/3 are associated with an unerupted tooth (usually canine)
49
Q
A

calcifying odontogenic cyst

50
Q
  • 10-year old female
  • parents brought her in for failure of her tooth to erupt
A

adenomatoid odontogenic tumor

notice the snowflake calculations

51
Q

what age range do adenomatoid odontogenic tumors occur in?

A

10-20

52
Q

AOTs have a tendency to occur in what location?

A

anterior jaws

more common in the maxilla and in females

53
Q

how are AOTs typically discovered?

A

they are asymptomatic and typically discovered radiographically to determine why a tooth hasn’t erupted

54
Q

how do AOTs present radiographically?

A
  • in 75% of cases, the tumor is a circumscribed, unilocular RL involving the crown of an unerupted tooth (most often a canine)
  • RL often extends apically past the CEJ
  • lesions may contain snowflake calcifications
55
Q

how can AOTs be distinguished radiographically from dentigerous cysts?

A

the RL often extends past the CEJ in AOTs, as opposed to stopping at the CEJ in dentigerous cysts

56
Q
A

adenomatoid odontogenic tumor

notice it is around an unerupted canine

57
Q
A

adenomatoid odontogenic tumor

58
Q
A

calcifying epithelial odontogenic tumor

59
Q

calcifying epithelial odontogenic tumor is also called a ___

A

pindborg tumor

60
Q

what is the most common location for a CEOT?

A

posterior mandible

61
Q

what is the most common presenting sign of a CEOT?

A

painless, slow-growing swelling

62
Q

what is the radiographic presentation of a CEOT?

A
  • can be unilocular or multilocular
  • unilocular is more common in the maxilla
  • margins are typically scalloped and well-defined, may be corticated or ill-defined
  • frequently associated with an impacted tooth (most often a mandibular molar)
  • contains calcified structures of varying size and density
  • some believe the clacifications are prominent around the crown in a “driven-snow” pattern (occurs in 10%)
63
Q

what are the histopathologic features of a CEOT?

A
  • nuclear pleophorphism and atypia
  • amyloid-like extracellular material, positive for congo red, which exhibits an apple-green birefringence when viewed under polarized light
  • calcifications with concentric rings form in the amyloid-like areas (liesegang rings)
64
Q
A

calcifying epithelial odontogenic tumor

the purple represents calficicaitons, and the light pink are the amorphous amyloid-like areas

65
Q
A

CEOT

the gray represents liesegang rings, and the white arrows point to cells exhibiting nuclear atypica and pleomorphism

66
Q
A

CEOT

positive for congo red

67
Q
A

compound odontoma

68
Q

what is the most common odontogenic tumor?

A

odontoma

69
Q

are odontomas true neoplasms?

A

no, they are considered to be developmental anolalies (hamartomas)

70
Q

what are the two types of odontomas? how do they differ from each other?

A
  • compound - multiple, small, toothlike structures
  • complex - conglomerate mass of enamel and dentin; bears no anatomic resemblance of a tooth
71
Q

what is the average age patient with an odontoma?

A

15

72
Q

odontomas are usually associated with a ___

A

unerupted tooth

73
Q

compound odontomas are more common in what location? what about complex odontomas?

A
  • compound - anterior maxilla
  • complex - molar regions
74
Q
A

compound odontoma

75
Q
A

complex odontoma

76
Q
A
77
Q
A
78
Q

ameloblastic fibromas are true mixed tumors, consisting of both ___ and ___ tissues

A

epithelial and mesenchymal tissues

79
Q

ameloblastic fibromas occur in what age patient?

A

younger, usually before age 20

80
Q

70% of ameloblastic fibromas are located in the ___, and 75% are associated with a ___

A

posterior mandible, unerupted tooth

81
Q
A

ameloblastic fibroma

82
Q
A

ameloblastic fibroma

83
Q
A

ameloblastic fibroma

84
Q
A

ameloblastic fibroma

85
Q

ameloblastic fibro-odontomas histologically appear similar to ameloblastic fibromas, except they also have ___

A

enamel and dentin

86
Q

what is the average age patient with an ameloblastic fibro-odontoma?

A

10

87
Q

ameloblastic fibro-odontomas typically occur in what location?

A

posterior jaws

88
Q

what is the radiographic presentation of an ameloblastic fibro-odontoma?

A
  • well-circumscribed unilocular radiolucency
  • contains varying amounts of calcified material
  • typically associated with an unerupted tooth
89
Q

what is the treatment for ameloblastic fibro-odontoma?

A

conservative curettage with rare recurrence

90
Q
A

ameloblastic fibro-odontoma

Oral Medicine (10 decks)

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