soft tissue masses exam 3 oral path

Fibroma

What is the most common “tumor” in the oral cavity

Buccal/labial mucosa, tongue and gingiva

Where can fibromas occur

Reactive hyperplasia due to injury

What is the cause of a fibroma

Excisional biopsy

What is the treatment of a fibroma

Smooth pink nodule

What is the presentation of a fibroma

Red/pink nodule with ulceration

What is the presenation of a peripheral ossifying fibroma

Only on the gingiva

Where can peripheral ossifying fibroma occur

Reactive process due to injury caused by plaqua and calculus

What causes peripheral ossifying fibroma

Excisional biopsy and remove local irritants

What is the treatment of peripheral ossifying fibroma

Pyogenic granuloma

What is also called the pregnancy tumor

Pink/red/purple mass with ulceration

What is the presenation of pyogenic granuloma

Most common on gingiva. Also lip, tongue, and buccal mucosa

Where can pyogenic granuloma occur

Excessive tissue response to local irritation, poor hygiene or hormones

What is the cause of pyogenic granuloma

Rapid growth

What is unique about about pyogenic granuloma

Excisional biopsy and remove local irritants

What is the treatment of pyogenic granuloma

Re/blue nodule on gingiva

What is the presentation of peripheral giant cell granuloma

Only on gingiva

Where can peripheral giant cell granuloma occur

Reactive process due to injury (plaque and calculus)

What is the cause of peripheral giant cell granuloma

Can see cupping resorption of alveolar ridge on xray

What is unique about peripheral giant cell granuloma

Excisional biopsy and remove local irritants

What is the treatment for peripheral giant cell granuloma

Plain fibroma, peripheral ossifying fibroma, pyogenic granuloma, and peripheral giant cell granuloma.

What are the 4P’s

Peripheral ossifying fibroma and peripheral giant cell granuloma

Which of the 4 P’s are only found on gingiva

Firms folds of hyperplastic tissue in the vestibule

What is the presentation of inflammatory fibrous hyperplasia

Ill fitting dentures

What is the cause of inflammatory fibrous hyperplasia

Excisional biopsy and better dentures

What is the treatment for inflammatory fibrous hyperplasia

Blue/gray dome like nodule of tissue that has salivary glands

What is the presenation of a mucocele

Labial mucosa

Where are mucocele most common

Gingiva

Where will a mucocele never occur

Ruptured salivary gland and spillage of mucin due to injury

What is the cause of mucocele

Can heal spontaneously or excisional biopsy that includes removal of feeding salivary gland

What is the treatment for mucocele

A form of a mucocele that occurs in the floor of the mouth

What is a ranula

Hard submucosal mass associated with a salivary gland and is radiopaque of xray

What is the presentation of a sialolith

Submandibular gland

What is the most common gland to present with a sialolith

Deposition of calcium salts around debri in salivary duct

What is the cause of a sialolith

Painful when eating

What is unique about a sialolith

Stimulate salivary flow via massage, moist heat, or surgical intervention

What is the treatment of a sialolith

Enlarged tender mobile lymph nodes

What is the presenation of reactive lymphadenopathy

Infection, allergies, immune reaction

What is the casue of reactive lymphadenopathy

Biopsy if persistent

What is the treatment of reactive lymphadenopathy

Firm non tender fixed unilateral lymph nodes

What is the presentation of lymphadenopathy secondary to malignancy

Direct spread from primary cancer/lymphoma/leukemia

What is the cause of lymphadenopathy secondary to malignancy

B symptoms (fever, weightloss, night sweats)

What symptoms are associated with lymphadenopathy secondary to malignancy

Biopsy and treat malignancy

What is the treatment of lymphadenopathy secondary to malignancy

Soft tissue swelling on hard palate associated with non-vital tooth

What is the presenation of a palatal abscess

Vitality testing, x-ray, treat infection

What is the treatment of a palatal abscess

Yellow red nodule on gingiva or vestibule associated with non-vital tooth

What is the presentation of a parulis

Vitality test, xray, treat infection

What is the treatment of a parulis

Pink with yellow hue sessile submucosal nodule on dorsal tongue

What is the presenation of a granular cell tumor

Benign

Is a granular cell tumor benign or malignant

Schwann cells

What is the cause of granular cell tumor

Excisional biopsy

What is the treatment for a granular cell tumor

More common in females

What is unique about granular cell tumors

Yellow or pink nodule associated with mucoa with fatty tissue (buccal mucosa or vestibule)

What is the presenation of a lipoma

Benign

Is a lipoma benign or malignant

Excisional biopsy

With is the treatment of lipoma

Red/blue/purple nodule occurring on head and neck

What is the presenation of hemangioma

Benign

Is a hemangioma benign or malignant

Rapid growth for 6-12 months in childhood and may spontaneously resolve

What is progression of a hemangioma

Excisional biopsy if they don’t sponanteously resolve

What is the treatment of a hemangioma

Pink/red/blue/purple mass associated with blood vessels

What is the presentation of a vascular malformation

A type of vascular malformation on the face associated with capillaries

What is a port wine stain

Blanching test

What is a diascopy test

Aspiration to confirm, angiogram if large, biopsy, no treatment

What is the treatment of vascular malformation

Pink nodule that can occur on tongue and buccal mucosa

What is the presentation of a neurofibroma/schwannoma

Excision biopsy

What is the treatment of a neurofibroma

Pink or skin colored swelling of major or minor salivary glands

What is the presentation of a salivary gland tumor

The smaller the gland the more likely to be malignant

What is the trend for major salivary glands being malignant

50% chance of malignancy

What the trend of minor salivary glands being malignant

Pleomorphism adenoma, mucoepidermoid carcinoma, polymorphous adenocarcinoma, and adenoids cystic carcinoma

What are the type of salivary glands tumors

Pleomorphic adenoma

What is the most common benign salivary tumor

Mucoepidermoid carcinoma

What is the most common malignant salivary tumor

Polymorphous adenocarcinoma

What maligant salivary tumor does not occur in major salivary glands

Adenoid cystic carcinoma

What maligant salivary tumor is the most aggressive and causes peri neural invasion

Local or surgical excision, parotidectomy, or total gland removal

What is the treatment for salivary glands tumor

Generalized boggy non tender swelling on gingiva with ulceration

What is the presentation of leukemia

Over production of neoplastic white blood cells

What is the cause of leukemia

Dyskeratosis, splenomegaly, hepatomegaly, and easy bruising

What symptoms are common with leukemia

Acute leukemia (immature WBC)

What form of leukemia is common in children

Chronic leukemia (mature WBC)

What form of leukemia is common in adults

Chemo and bone marrow transplant

What is the treatment of leukemia

Enlarging non tender mass in lymph node region such as vestibule, hard palate, and gingiva

What is the presentation of lymphoma

Weightloss and pruitus

What symptoms are associated with lymphoma

Diffuse large B cell lymphoma

What type of lymphoma causes oral lymphoma

Biopsy and chemo

What is the treatment of lymphoma

Multiple blue/purple macule or nodules on face or oral mucosa

What is the presentation of kaposi sarcoma

Har palate, tongue, and gingiva

Where are oral lesions of kaposi sarcoma most common

HHV-8 infection associated with AIDs or immunosupression

What is the cause of kaposi sarcoma

AIDs-relates Kaposi sarcoma

What the most common form of kaposi sarcoma in the US

Biopsy, chemo, AIDs treatment

What is the treatment of kaposi sarcoma

Modular soft tissue mass on gingiva looks similar to the 4P’s

What is the presentation of metastatic tumor

Lung, kidney, and melanoma

What are the main causes of metastatic tumor in men

Lung, kidney, breast, genital

What re the main causes of metastatic tumor in women

Treat the primary malignancy

What is the treatment of metastic tumor

Mass in anterior midline of the neck

What is the presentation of thyroid gland enlargement

Goiter

What is the most common cause of thyroid gland enlargement

Graves’ disease, Hashimoto’s thyroiditis, thyroid adenoma, and thyroid carcinoma

What are other causes of thyroid gland enlargement

Fine needle aspiration, blood work and treat cause

What is the treatment for thyroid gland enlargement

Pink Soft tissue mass on gingiva

What is the presentation of peripheral odontogenic cyst/tumor

Peripheral ameloblastoma and peripheral calcifying epithelial odontogenic tumor

What is the casues of peripheral odontogenic cyst/tumor