Oral Facial And Bone Neoplasms

Question 1

What is neoplasia?

Answer 1

New growth

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

Question 2

Neoplasias are categorised as either ……………….. or …………………. ?

Answer 2

Benign or Malignant

Question 3

Benign Vs Malignant:
- Differentiation?
- Rate of growth?
- Local Invasion?
- Metastasis?

Answer 3

Question 4

Appearance of benign vs malignant tumour?

Answer 4

Question 5

Examples of benign oral neoplasias? (9)

Answer 5

Question 6

Heamangioma

Answer 6

Blue typically
• Benign vasoformative neoplasm
• Capillary or cavernous
• Blanch on pressure
• May cause troublesome bleeding or cosmetic defect
• Treat by cryotherapy / sclerotherapy / excision

Question 7

Lipoma

Answer 7

• Benign neoplasm of adipose tissue
• Occur anywhere there is subcutaneous / dermal fat
• Soft yellow or pink with normal overlying mucosa / skin
• Treat with surgical excision

Question 8

Fibroepithelial Polyp (FEP)

Answer 8

• Most common benign epithelial tumour of oral cavity
• Painless flat or pedunculate lesion
• Uncommon before age 30
• Inflammatory hyperplasia due to chronic irritation eg cheek biting
• Local surgical excision if troublesome

Question 9

Papilloma

Answer 9

• Benign proliferating lesion caused by human papilloma virus
• Most common between age 30 - 50
• HPV 6 and 11 (not cancer inducing type 16 + 18 )
• Soft palate and tongue most common
• Local surgical excision or cryotherapy if troublesome

Question 10

Melanocytic Naevi

Answer 10

• Pigmented mole
• Develop in childhood and early adult life (30 - 40)
• Runs in families (sun exposure / sun burn)
• Local surgical excision if troublesome or concern

Question 11

Pyogenic Granuloma

Answer 11

• Reactive hyperplasia of connective tissue (no pus and not a granuloma!!)
• Low grade irritation, trauma, poor oral hygiene, hormonal change
• Gingiva, buccal mucosa, tongue and lips
• F > M most common in second decade
• Local surgical excision (including base) plus improved OH

Question 12

Ameloblastoma

Answer 12

• Benign tumour of odontogenic epithelium
• 80% in mandible most commonly posterior region
• Expansion, resorption of adjacent tooth roots
• Locally invasive (very rarely metastatic spread to lung)
• Surgical excision with margin / enucleation possible

Question 13

Pleomorphic Adenoma

Answer 13

• Most common salivary gland tumour 80%
• Parotid gland commonly affected
• F>M 2:1
• Any age but most frequent in 30 - 60 year olds
• Careful surgical excision required

Question 14

Bony Exostosis / Torus

Answer 14

• Benign localised peripheral overgrowth of bone
• Most common in palate and lingual aspect mandible
• Frequently traumatised due to location and thin mucosa
• Surgical reduction if functionally / cosmetically problematic

Question 15

Summary

Answer 15

• Benign neoplasia is common in the oral cavity
• Slow rate of growth and normality of surrounding structures
• Many do not need treatment
• If in doubt monitor with regular review, photos or Xray
• Refer if concern of potential malignancy