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AU'18 Oral Path II > Odontogenic Neoplasms - part I > Flashcards

Odontogenic Neoplasms - part I Flashcards

1
Q

odontogenic neoplasms

A
  1. tumors of odontogenic epithelium
  2. mixed tumors of odontogenic epithelium and odontogenic ectomesenchyme
  3. tumors of odontogenic ectomesenchyme
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2
Q

tumors of odontogenic epithelium

A
  1. ameloblastoma
  2. adenoid odontogenic tumor (AOT)
  3. calcifying epithelial odontogenic tumor (CEOT, Pindborg tumor)
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3
Q

mixed tumors of odontogenic epithelium and odontogenic ectomesenchyme

A
  1. ameloblastic fibroma
  2. ameloblastic fibro-odontoma
  3. odontoma
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4
Q

tumors of odontogenic ectomesenchyme

A
  1. odontogenic myxoma

2. cementoblastoma

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5
Q

T/F: ameloblastoma is benign but locally aggressive

A

true

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6
Q

clinical features of ameloblastoma

A
  1. painless

2. slow growing

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7
Q

T/F: the frequency of ameloblastoma equals combined frequency of all other odontogenic tumors

A

true

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8
Q

what gender predilection does ameloblastoma have?

A

no gender predilection

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9
Q

T/F: ameloblastoma usually expands rather than perforates bone

A

true

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10
Q

T/F: expansion from ameloblastoma can be dramatic

A

true

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11
Q

list the order of sites from most to least affected by ameloblastoma

A
  1. post mand (66%)
  2. mand PM region (11%)
  3. anterior mand (10%)
  4. anterior and posterior max (6%)
  5. max PM region (1%)
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12
Q

where does most ameloblastoma appear radiographically?

A

most in molar/ramus region of mand, but can occur anywhere

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13
Q

radiographic features of ameloblastoma

A
  1. unilocular/multilocular with well-defined but not sclerotic borders esp small lesions
  2. may displace teeth/resorb roots
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14
Q

what does multilocular expansile radiolucency due to ameloblastoma look like radiographically?

A

“soap bubble” or “honeycomb”

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15
Q

histopathologic features of ameloblastoma

A
  1. no enamel produced by lesional cells
  2. several different patterns
  3. tumor often infiltrates bony trabeculae (recurrence)
  4. tumor islands showing cuboidal or columnar cells at periphery
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16
Q

what does ameloblastoma resemble histopathologically?

A

ameloblasts of the enamel organ

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17
Q

what are the 2 most common patterns seen of ameloblastoma microscopically?

A
  1. follicular

2. plexiform

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18
Q

what is the center of tumor islands in ameloblastoma seen histopathologically composed of?

A

loosely arranged polyhedral epithelial cells that resemble stellate reticulum

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19
Q

what are the cubodial or columnar cells at the periphery seen histopathologically of ameloblastoma?

A
  1. ameloblast-like cells with reverse polarization

2. nuclei are polarized AWAY from the basement membrane

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20
Q

follicular pattern of ameloblastoma seen histopathologically

A
  1. islands with hyperchromatic, palisaded basal cells showing reverse polarization
  2. central zones resemble stellate reticulum
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21
Q

plexiform patter of ameloblastoma seen histopathologically

A

anastomosing cords of odontogenic epithelium

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22
Q

T/F: unicystic cysts can only be seen microscopically

A

true

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23
Q

what is the reason for en bloc resection of ameloblastoma?

A

insinuates through trabeculae

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24
Q

tx of ameloblastoma depends on what?

A
  1. size

2. site

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25
tx of small ameloblastoma
aggressive curettage or small en bloc resection
26
tx of large ameloblastoma
large en bloc resection or segmental resection with reconstruction
27
why are maxillary ameloblastoma lesions tx'd more aggressively?
due to anatomic location (vital structures)
28
px of ameloblastoma
guarded
29
T/F: there is a higher recurrence of ameloblastoma if tx is simple curettage
true
30
T/F: ameloblastoma cannot be fatal
false, can be esp max lesions
31
T/F: it;s common for ameloblastoma to transform
false, rare
32
how many years after tx | ing ameloblastoma should a radiogrpahic follow-up be done for?
annual radiographic f/u for 8-10 yrs
33
periapical ameloblastoma
soft tissue variant of ameloblastoma
34
clinical features of periapical ameloblastoma
1. gingival mass | 2. less than 2 cm
35
what can periapical ameloblastoma look like clinically?
gingival bumps
36
T/F: peripheral ameloblastoma is symptomatic
false, asymptomatic
37
where does peripheral ameloblastoma usually affect?
mand, post
38
who is affected by peripheral ameloblastoma?
middle-aged adult
39
radiographic features of peripheral ameloblastoma
no radiographic findings... no, or limited bone involvement (may have superficial erosion)
40
peripheral ameloblastoma is histopathologically similar to conventional ameloblastoma except what?
lesion is located under the surface epithelium
41
tx of peripheral ameloblastoma
biopsy is often curative if innocuous lesion
42
T/F: pts with AOT often have no change to their alveolar bone
true
43
clinical features of AOT
1. can have expansion/swelling | 2. asymptomatic
44
T/F: peripheral AOT (soft tissue) is common
false, rare
45
what is the gender predilection for AOT?
2:1 female predilection
46
what is the location predilection for AOT?
2:1 maxillary predilection
47
the most common site for AOT
anterior jaws
48
majority of AOT cases are associated with what?
impacted tooth
49
list the order from most to least common sites for AOT
1. anterior max (53%) 2. anterior mand (27%) 3. max PM region (9%) 4. mand PM region (7%) 5. post max and mand (2%)
50
T/F: AOT is often an incidental finding on radiographs
true
51
radiographic features of AOT
1. well-circumscribed unilocular radiolucency 2. ± radiopaque flecks 3. often causes divergence of adjacent roots 4. pericoronal lucency may extend apically beyond CEJ
52
histopathologic features of AOT
1. well-developed capsule 2. swirling spindle-cell nests and duct-like structures "adenomatoid" 3. foci basophilic calcified material may be seen
53
tx of AOT
enucleation
54
prognosis of AOT
excellent
55
T/F: recurrence of AOT is common
false, rare
56
what is calcifying epithelial odontogenic tumor (CEOT) also known as?
Pindborg tumor
57
before CEOT was described by Pindborg in 1956, what was it probably confused with?
ameloblastoma
58
histogenesis of CEOT presumes what?
stratum intermedium
59
Is CEOT common?
no, rare
60
what is the gender predilection for CEOT?
no gender predilection
61
what is the location predilection for CEOT?
2:1 mand, usually posterior
62
clinical features of CEOT
1. may have expansion | 2. asymptomatic
63
what is CEOT associated with?
impacted tooth
64
list the order from most to least common sites for CEOT
post mand (57%) > post max (21%) > anterior mand (14%) > anterior max (8%)
65
radiographic features of CEOT
1. well-circumscribed radiolucency when small, multilocular when enlarges 2. margins well-defined but may be ill-defined 3. ± radiopaque flecks
66
what is the pattern of the radiopaque flecks seen with CEOT?
"driven snow" pattern
67
histopathologic features of CEOT
1. proliferation of polyhedral epithelial cells with eosinophilic cystomplasm 2. nuclei frequently pleomorphic 3. rare mitoses 4. calcifications
68
the epithelial cells seen with CEOT histopathologically is associated with what?
amyloid (eosinophilic, homogenous)
69
what are the calcifications of CEOT seen histopathologically called?
Liesegang rings (lamellated)
70
tx of CEOT
1. conservative excision | 2. periodic radiographic follow-up
71
T/F: radical surgery is warrented in tx'ing CEOT
false, is not
72
px of CEOT
good

AU'18 Oral Path II (31 decks)

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