Odontogenic Neoplasms (3)

Question 1

What are the three categories of odontogenic neoplasms?

Answer 1

1. Tumor of odontogenic epithelium (enamel organ)
2. Mixed tumors (odontogenic epithelium and odontogenic ectomesenchymal)
3. Odontogenic ectomesenchymal (dental papilla)

Question 2

What are the three neoplasms of odontogenic epithelium?

Answer 2

1. Ameloblastoma
2. Adenoid odontogenic tumor
3. Calcifying epithelial odontogenic tumor

Question 3

What are the three odontogenic neoplasms of mixed origin?

Answer 3

1. Ameloblastic fibroma
2. Ameloblastic fibro-odontoma
3. Odontoma

Question 4

What are the two neoplasms of odontogenic mesenchymal origin?

Answer 4

1. Odontogenic myxoma

2. Cementoblastoma

Question 5

T/F: Ameloblastomas are benign, painless tumors.

Answer 5

True

Question 6

What is the most frequent tumor of odontogenic origin?

Answer 6

Ameloblastoma

Question 7

T/F: Ameloblastomas will often perforate the bone.

Answer 7

False

Will cause dramatic expansion of bone

Question 8

What is the most common location for Ameloblastomas?

Answer 8

Posterior mandible

Question 9

T/F: Ameloblastoma radiolucencies are often described as “soap bubble” or “honeycomb”.

Answer 9

True

Question 10

T/F: Enamel is produced by ameloblastoma cells.

Answer 10

False

Resemble ameloblasts but no enamel is produced

Question 11

What attributes to the recurrence of ameloblastomas?

Answer 11

Tumor often infiltrates bony trabeculae

Question 12

What are the two common histopathological patterns seen in ameloblastomas?

Answer 12

Follicular and plexiform

Question 13

Ameloblastomas are seen as __________ showing cuboidal or columnar cells at the periphery.

Answer 13

Tumor islands

Question 14

T/F: Ameloblastomas have cells with nuclei polarized away from the basement membrane.

Answer 14

True

Reverse polarization

Question 15

What are the treatment options for an ameloblastoma?

Answer 15

Small - aggressive curettage or small en bloc resection

Large - large en bloc resection or segmental resection

Question 16

What is the prognosis of an ameloblastoma?

Answer 16

Guarded

Simple curettage recurrence 50%-90%

Resection recurrence 15%

Rare malignant transformation

Question 17

What is a peripheral ameloblastoma?

Answer 17

Soft tissue variant of an ameloblastoma

Seen as gingival bumps

Question 18

T/F: Peripheral ameloblastomas will be seen as a radiolucency on a radiograph.

Answer 18

False

No radiographic findings

Question 19

What is the treatment/prognosis for peripheral ameloblastoma?

Answer 19

Biopsy/local excision

Limited recurrence

Question 20

______________ is an asymptomatic tumor of odontogenic epithelium often seen in patients under 20 y.o.

Answer 20

Adenomatoid odontogenic tumor (AOT)

Question 21

T/F: Odontogenic myxomas are sometimes seen in bones other than the jaw.

Answer 21

False

Only in the jaw bones

Question 22

T/F: Odontogenic myxomas can have a soap bubble radiographic appearence.

Answer 22

True

Odontogenic myxoma and ameloblastoma

Question 23

What is a good way to differentiate an ameloblastoma and odontogenic myxoma based off of radiographs?

Answer 23

Odontogenic myxoma has thin wispy trabeculae at right angles

Question 24

T/F: Odontogenic myxomas can cause root displacement and resorption.

Answer 24

True

Question 25

____________ is characterized histopathologically by spindle-shaped or stellate-shaped fibroblastic cells set in a myxoid background.

Answer 25

Odontogenic myxoma

Question 26

What can lead to recurrence of odontogenic myxoma?

Answer 26

Lesional proliferation tends to infiltrate adjacent bony trabeculae

Question 27

What is the treatment/prognosis for odontogenic myxomas?

Answer 27

Small - curettage Large - En bloc or segmental resection Good; can recur

Question 28

_____________ is a tumor of odontogenic ectomesenchyme that is often seen in patients under 25 y.o. In the mandibular first molar region.

Answer 28

Cementoblastoma

Question 29

T/F: Cementoblastomas will often cause pain and swelling.

Answer 29

True

Question 30

What is the radiographic appearance of a cementoblastoma?

Answer 30

Well-circumscribed radiopaque mass with fine radiolucent border fused to the root

Question 31

What is a major distinguishing histopathological feature of a cementoblastoma?

Answer 31

Fused to the root Resembles cementum

Question 32

What is the treatment/prognosis for cementoblastoma?

Answer 32

Surgical extraction of tooth with lesion RCT tooth and root amputation of affected root and lesion Excellent

Question 33

Where is the most common place to see an adenomatoid odontogenic tumor (AOT)?

Answer 33

Anterior maxilla on a female Also 75% associated with impacted tooth

Question 34

T/F: An AOT will sometimes have radiopaque flecks seen within the radiolucency.

Answer 34

True

Question 35

What are the histopathological features of an AOT?

Answer 35

Well-developed capsule Swirling spindle-cell nests Possible basophilic calcified material

Question 36

What is the treatment/prognosis of an AOT?

Answer 36

Enucleation Excellent

Question 37

What is another name for a Calcifying epithelial odontogenic tumor (CEOT)?

Answer 37

Pindborg tumor

Question 38

What is the histogenesis of a CEOT?

Answer 38

Stratum intermedium

Question 39

What is the most common location for a CEOT?

Answer 39

Posterior mandible

Question 40

What are some radiographic features of a CEOT?

Answer 40

Radiolucency with possible radiopaque flecks in a “driven snow” pattern

Question 41

What is the treatment/prognosis for CEOT?

Answer 41

Conservative excision Good

Question 42

T/F: An ameloblastic fibroma involves both epithelial and ectomesenchyme cells.

Answer 42

True

Question 43

T/F: Ameloblastic fibromas are most often seen in adults.

Answer 43

False 1st-2nd decade

Question 44

Where is an ameloblastic fibroma most likely to be seen?

Answer 44

Posterior mandible

Question 45

What does an ameloblastic fibroma look like histopathologically?

Answer 45

Myxoid connective tissue with strands and islands of epithelium

Question 46

What is the treatment/prognosis for an ameloblastic fibroma?

Answer 46

Aggressive curettage Good

Question 47

What is the average age of a patient who develops an ameloblastic fibro-odontoma?

Answer 47

10 y.o.

Question 48

T/F: Ameloblastic fibro-odontomas are seen more often in the posterior mandible.

Answer 48

False Equal maxilla and mandible

Question 49

______________ will be seen with varying amounts of calcifying material the same density of the tooth. It is typically associated with failed tooth eruption.

Answer 49

Ameloblastic fibro-odontoma

Question 50

What is the treatment/prognosis of ameloblastic fibro-odontoma?

Answer 50

Conservative excision Excellent

Question 51

What are the two forms of odontomas and their likely locations?

Answer 51

1. Compound - anterior jaw | 2. Complex - posterior jaw

Question 52

Odontomas are not true neoplasms, but rather an ______________.

Answer 52

Odontogenic hamartoma

Question 53

What age is the patient most likely to develop odontoma?

Answer 53

1st-2nd decade

Question 54

What is the radiographic appearance of a compound and complex odontoma?

Answer 54

Compound - anterior jaw, collection of small malformed teeth surrounded with radiolucent rim Complex - posterior jaw, calcified mass surrounded by narrow radiolucent rim *both often overly an impacted tooth

Question 55

T/F: A complex odontoma is a formation of multiple small malformed teeth.

Answer 55

False Compound

Question 56

What is the treatment/prognosis for odontoma?

Answer 56

Enucleation Excellent