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mckaylacarman
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What is neoplasia?
The unregulated formation and growth of new tissue- uncontrolled proliferation.
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What is a neoplasm?
TUMOR- mass of cells that have undergone uncontrolled growth.
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What is hyperplasia?
- Overgrowth of tissue in response to stimuli
- *Stops when the stimuli is removed
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What is dysplasia?
Disordered growth
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What is metastasis?
Transport of neoplastic cells to parts of the body remote from the tumor
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What are the two types of malignant neoplasms?
1. Carcinoma- cancers of epithelial orgin (squamous/basal cell carcinoma)
2. Sarcoma- cancers of connective tissue orgin (osteosarcoma/fibrosarcoma)
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(Squamous Epithelium Tumors)
Papilloma
- Benign, exophytic or sessile- core fibrous CT
- MC: soft palate/tongue
- White b/c surface keratin
(resembles: warts)
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(Squamous Epithelium Tumors)
Leukoplakia
- Generic clinical term- white patch, cannot be rubbed off (b/c hyperkeratosis)
- PREMALIGNANCY (can show epithelial displasia) *always biopsy
- 16%= squamous cell carcinoma (malignant)
MC: floor of mouth, ventral/lateral tongue
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(Squamous Epithelium Tumors)
Erythroplakia
- Generic clinical term- red, premalignant speckled leukoplakia (red and white)
- *Much less common than leukoplakia 60:1, more likely to be dysplasia, squamous cell carcinoma
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(Squamous Epithelium Tumors)
Epithelial dysplasia
- Histological diagnosis
- Premalignant
- Histologically:
- -abnormal maturation
- -hyperplasia of basal cells
- -disorganization of layers
- -hyperchromatic nuclei
- -increased mitotic figures
- -no invasion through the basement membrane
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Carcinoma in situ vs Squamous cell cancer
Carcinoma in situ: severe dysplasia involving full thickness of epithelium
Squamous cell cancer: all histological characteristics plus invasion through basement membrane
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(Squamous Epithelium Tumors)
Squamous Cell Carcinoma
(Epidermoid Carcinoma)
- Most common malignancy in oral cavity
- -usually metastasizes to lymph nodes
- -invasion through basement membrane; keratin pearls (keratin seen in the cells within the tumor)
- MC: floor of the mouth, ventrolateral tongue, soft palate
- Assoc. w/ solar/actinic cheilitis
- Males > 40 --tobacco/alcohol increases risk
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What does TNM stand for?
- T: tumor, what is the size of the primary tumor?
- N: nodes, which lymph node involvement?
- M: metastasis, how far has the tumor spread?
- ***Any pt with metastasis = stage IV***
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(Squamous Epithelium Tumors)
Verrucous Carcinoma
- A squamous cell carcinoma w/ better prognosis due to slow growth
- -Exophytic/pebbly
- -No invasion of basement membrane (rare to metastasize, well differenciated)
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(Squamous Epithelium Tumors)
Basal Cell Carcinoma
- NOT in oral cavity
- Raised pearly boarders w/ visible capillary network surrounding a central depressed, crusted area
- -sun ☀ exposure, ulcer like
- -rare to metastasize
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(Salivary Gland Tumors)
Pleomorphic Adenoma
- Most common salivary gland tumor
- 90% benign
-- CAN undergo malignant transformation - -CT and ep
- -Painless, slow enlarging
- MC: palate
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(Salivary Gland Tumors)
Monomorphic Adenoma
- -Benign
- -Epithelium only
- MC: upper lip
- -Warthin's Tumor
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Papillary Cystadenoma Lymphomatosum
(Warthin's Tumor)
- -Special kind of monomorphic adenoma
- -Epithelial and lymphoid tissue
- -Benign
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(Salivary Gland Tumors)
Adenoid Cystic Carcinoma
- Malignant
- -infiltrates, pain, slow growing
- -CAN have distant metastasis years later
- MC: parotid gland (extraoral), palate (intraoral)
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(Salivary Gland Tumors)
Mucoepidermoid Carcinoma
- Malignant
- Most common malignant salivary tumor in children
- -mucous and epithelial cells
- -slow enlarging
- -uni/mulilocular, radiolucent, invasive
- MC: parotid, palate, in bone
- -low grade tumor 5 year survival: 92%
- -high grade tumor 5 year survival: 49%
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Are most odontogenic tumors benign or malignant?
Benign
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(Odontogenic Tumors)
Ameloblastoma
- -Benign, unencapsulated
- -Bone expansion, painless, slow growing
- -Locally aggressive
- -Ameloblast ep cells surrounding stellate reticulum
- -uni/multilocular, soap bubble-80% mand (ramus/molar areas)
- -Max (molar areas)
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(Odontogenic Tumors)
Calcifying Epithelial Odontogenic Cyst
(Pindborg Tumor)
- -Benign, unique sheets of multi-sided ep cells with calcifications
- -Remnants of the enamel organ-Uni/multi
- -Mand > -premolar/molar-Many assoc w/ impacted teeth
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(Odontogenic Tumors)
Adenomatoid Odontogenic Tumor
- -Benign, does not recur
- -Duct-like structures, fibrous CT capsule
- -70% females under 20, ant max-asymptomatic
- -well defined RL w/ impacted tooth
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(Odontogenic Tumors)
Calcifying Odontogenic Cyst
- -Nonaggressive
- -Radiographic ghost cells (keratin w/ lost nuclei), uni/multi
- -May resemble ameloblastoma
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Males under 40
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(Odontogenic Tumors)
Odontogenic Myoxoma
- -Benign, unencapsulated
- -Derived from ectomesenchyme, originates from PDL and pulp-10-30 years-Root resorption and displacement, multi, RL w/ poor margins
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(Odontogenic Tumors)
Central and Ossifying Fibromas
- -Benign, fibrous CT calcifications
- -Female 30's and 40's-Well defined, RL
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(Odontogenic Tumors)
Benign Cementoblastoma
- Cementum tumor
- Lesion fused to root, tooth may be vital
-Well defined RO w/ resorbed apex and RL halo - -premolar, molar mand
- -Younger than 25
- -Pain
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(Odontogenic Tumors)
Ameloblastic Fibroma
(Fibroodontoma)
- -Benign, unencapsulated
- -Younger than 20-Mandibular premolars
- -RL may be assoc w/ unerupted tooth
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(Odontogenic Tumors)
Odontoma
- Most common odontogenic tumor
- -Mature enamel, dentin, cementum, pulp
- -Females younger than 20-Asymptomatic, found in routine radiographs
- TWO TYPES
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What are the two types of odontomas?
1. Compound: resembles small teeth (cluster of calcified material); ant max
2. Complex: Masses of tissue NOT resembling a tooth; post mand
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(Odontogenic Tumors)
Peripheral Ossifying Fibroma
- Well defined sessile/pedunculated/exophytic mass on attatched gingiva-Develops from submucosal CT or PDL-Surface may be ulcerated
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(Tumors of Soft Tissue)
Lipoma
- Most common soft tissue tumor of the body
- -Benign, adipose cells, yellow
- -Soft/palpable
- -Rare recurrence
- -Around 50 years old
***Lipsarcoma: rare in oral cavity, can recur***
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(Tumors of Soft Tissue)
Neurofibroma
- -Benign, solitary nerve tissue neoplasm
- MC: Tongue
- *Neurofibromatosis
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What is neurofibromatosis?
Von Recklinghausen's Disease: multiple neurofibromas
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(Tumors of Soft Tissue)
Neurolemoma
(Schwannoma)
- -Proliferation of Schwann cells
- -Nerve pushed aside as tumor grows, slow growing
- -20-50 years of age
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(Tumors of Soft Tissue)
Granular Cell Tumor
- -Large cells w/ granular cytoplasm
- -Tongue, painless
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(Tumors of Muscle)
Rhabdomyoma and sarcoma
Rhabdomyoma- benign, striated
- Rhabdosarcoma- malignant, striated, rapid, destructive
- Most common malignant soft tissue tumor in children
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(Vascular Tumors)
Hemangioma
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