Oral, facial and bone neoplasms

Question 1

What does neoplasia mean?

Answer 1

New growth

Question 2

What is the definition of neoplasm?

Answer 2

It is an abnormal growth that exceeds normal tissue. It is uncoordinated and persists after the cessation of the stimulus that caused it

Question 3

What 4 characteristics may you consider when assessing a neoplasm?

Answer 3

Differentiation
Rate of growth
Local invasion
Metastasis

Question 4

What characteristics may indicate that a neoplasm is benign?

Answer 4

Well differentiated (looks like tissue of origin with organised structure)

Usually slow rate of growth

Normally well circumscribed with no invasion

Absent metastasis

Question 5

What characteristics may indicate that a neoplasm is malignant?

Answer 5

Un-differentiated (looks different to tissue of origin with disorganised structure)

Likely to have rapid growth

Invasive with poorly defined margin

Commonly metastases

Question 6

Name 3 benign oral neoplasia

Answer 6

• Haemangioma (small collection of blood vessels under mucosa)
• Lipoma
• Fibroepithelial polyp
• Papilloma
• Naevus
• Pyogenic granuloma
• Ameloblastoma
• Pleomorphic adenoma
• Bony exostosis

Question 7

Describe a haemangioma (4)

Answer 7

Benign vasoformative neoplasm

Capillary or cavernous

Blanches on pressure

May cause troublesome bleeding or cosmetic detect

Question 8

How do you treat a haemangioma? (3)

Answer 8

Cryotherapy

Sclerotherapy (inject solution into vessels, causing it to scar and forces blood to reroute and go to other vessels)

Excision

Question 9

What is a lipoma?

Answer 9

Benign neoplasm of adipose tissue

Question 10

Where can a lipoma occur?

Answer 10

Anywhere there is subcutaneous/dermal fat

Question 11

What does a lipoma look like?

Answer 11

Soft yellow or pink with normal overlying mucosa/skin

Question 12

How would you treat a lipoma?

Answer 12

Surgical excision

Question 13

What is the most common benign epithelial tumour of the oral cavity?

Answer 13

Fibroepithelial Polyp (FEP)

Question 14

What is a fibroepithelial polyp?

Answer 14

It is a painless flat or pedunculate (has stalk or stem) lesion. It is inflammatory hyperplasia due to chronic irritation (e.g. cheek biting).

It is uncommon before the age of 30

Question 15

How would you treat a fibroepithelial polyp?

Answer 15

Local surgical excision if troublesome

Question 16

What is a papilloma?

Between what ages is it most common?

Answer 16

Benign proliferating lesion caused by human papilloma virus.

30-50.

Question 17

Where do papillomas most commonly occur?

Answer 17

Soft palate and tongue

Question 18

What HPV causes papilloma?

Answer 18

HPV 6 and 11

Question 19

How would you treat a papilloma? (2)

Answer 19

Local surgical excision or cryotherapy (if troublesome)

Question 20

What is a melanocytic naevi?

Answer 20

It is a pigmented mole, which often runs in families

Question 21

When are melanocytic naevi most likely to develop?

Answer 21

In childhood and early adult life (30-40)

Question 22

How may you treat a melanocytic naevi?

Answer 22

Local surgical excision (if it is a concern or troublesome)

Question 23

What is a pyogenic granuloma?

Answer 23

Reactive hyperplasia of connective tissue (no pus and not a granuloma) - they appear as small, raised red bumps that bleed easily due to high number of blood vessels

Question 24

Are pyogenic granulomas more common in men or women?

Answer 24

Women

Question 25

Where are pyogenic granulomas most likely to occur? (4)

Answer 25

Gingiva
Buccal mucosa
Tongue
Lips

Question 26

What may cause a pyogenic granuloma? (4)

Answer 26

Low grade irritation
Trauma
Poor OH
Hormonal change

Question 27

How would you treat a pyogenic granuloma?

Answer 27

Local surgical excision plus improved OH

Question 28

What is an ameloblastoma?

Answer 28

Benign tumour of odontogenic epithelium

Question 29

Where would you find the majority of ameloblastoma?

Answer 29

80% in the mandible (most commonly posterior region)

Question 30

Describe the characteristics of ameloblastoma

Answer 30

Expansion, resorption of adjacent tooth roots.

Locally invasive (very rarely can metastatically spread to lung)

Question 31

How would you treat ameloblastoma?

Answer 31

Surgical excision with margin/enucleation possible

Question 32

What is the most common salivary gland tumour?

Answer 32

Pleomorphic adenoma (80%)

Question 33

What gland is most commonly affected by pleomorphic adenoma?

Answer 33

Parotid gland

Question 34

In what ratio does pleomorphic adenoma affect females and males? F:M

Answer 34

2:1
F:M

Question 35

Pleomorphic adenoma can occur at any age, but between what ages is it most frequent?

Answer 35

30-60 years

Question 36

How would you treat a pleomorphic adenoma?

Answer 36

Careful surgical excision

Question 37

What is bony exostosis/torus?

Answer 37

Benign localised peripheral overgrowth of bone

Question 38

Where are bony exostosis/torus most commonly found?

Answer 38

Palate and lingual aspect of mandible

Question 39

Why may a patient may want to remove or reduce their bony exostosis/torus?

How would this be treated?

Answer 39

Because they can be frequently traumatised due to location and thin mucosa.

Can be surgically reduced if functionally/cosmetically problematic

Question 40

If you are doubtful about a benign neoplasm in the oral cavity, what would you do?

Answer 40

Regularly review, take photos and x-rays

Refer if concerned of potential malignancy