45. BENIGN SOFT TISSUE TUMORS OF SKIN AND ORAL CAVITY

explain the features of benign tumours

slow growing

regular, capsulated surface

non-invasive

don't spread/metastasise

unlikely to reoccur

no bleeding on cut surfaces

cells produce adhesion molecules so they stick together

what are the epithelial tissue benign tumours?

1. of stratified squamous tissue

- papilloma

- seborrheic keratosis

- skin adnexal tumours

2. of glandular epithelium

- adenoma

3. of transitional epithelium

- transitional cell papilloma

what are the muscle benign tumours?

1. of smooth muscle

- leiomyoma

2. of striated muscle

- rhabdomyoma

what are the neural benign tumours?

1. of nerve cells

- ganglioneuroma

2. of meninges

- meningioma

3. of nerve sheath

- schwannoma

- neurilemmoma

- neurofibroma

what are the endothelium benign tumours?

1. of blood vessels

- haemangioma

- haemangiopericytoma

2. of lymph vessels

- lymphangioma

what are the connective tissue benign tumours?

1. of adult fibrous tissue

- fibroma

2. of embryonic fibrous tissue

- myxoma

3. of fat

- lipoma

4. of cartilage

- chondroma

5. of bone

- osteoma

6. of connective tissue

- fibrous histiocytoma

explain which tissue a squamous papilloma is from?

stratified squamous epithelium

what is the etiology of squamous papilloma?

induced by HPV 6 and 11

females and men equally affected

what is the clinical appearance of squamous papillomas?

usually on the soft palate, tongue, lips and cheeks

soft, painless, pedunculated projections

look like cauliflowers

the colour depends on the level of keratinisation (more keratinised = more white)

what is the treatment for a squamous papilloma?

surgical excision

- must remove the base of the lesion

- use cryotherapy, laser or electrosurgery

which tissue are fibromas derived from?

connective tissue

what is the etiology of a fibroma?

depends on where it is in the body

- plantar area- unknown etiology

- angiofibroma- genetics

- oral fibromas- injury and trauma

what is the clinical appearance of a fibroma?

smooth surfaced pink nodule

in black patients they can look grey/brown

asymptomatic

what is the treatment of fibromas?

surgical excision

which tissues are lipomas derived from?

fat tissue

what is the etiology of lipomas?

unknown

trauma

explain the clinical appearance for lipomas?

surgical excision

what is Madelung's disease?

this is a type of lipoma

due to unusual fat metabolism

causes a neck accumulation of fat

what is the clinical appearance of myomas?

solid and painless

more common on the tongue (can make swallowing difficult)

which tissue is a haemangioma derived from?

vascular tissue (endothelium)

what are the types of haemangioma?

1. haemangioblastoma

- slow growing

- well defined

2. haemagniopericytoma

- rare

- originates in cells around the blood vessels of meninges

explain the clinical features of a haemangioma

birthmark appearance

bright red/rubbery nodule

grows during first year of life

shrinks until almost invisible

when is treatment of haemangioma necessary?

when it impairs breathing or vision

what are the methods of treatment for haemangioma?

1. sclerosing agents (like ethanol)

- inject into lesion

- inflammation causes vessel fibrosis and obliteration

2. irradiation

- when lesion is large

3. cryotherapy

- successful for small lesions

4. embolisation

- injection of isobutyl cyanoacrylate into vessels

what are lymphangiomas?

congenital malformations involving the blood vessels of lymph nodes

what is the classification of lymphangiomas?

1. simplex

- small, thin walled lymph vessels

2. cavernous

- dilated lymph vessels

3. cystic

- huge, macroscopic lymphatic vessels

4. benign lymphangioendothelioma

- lymphatic channels dissect through dense collagen bundles

what are schwannomas?

benign nerve sheath tumours

the Schwann cells create myelin sheaths

explain the clinical appearance of schwannomas

tumour will stay on the outside of the nerve but it can push the nerve against other structures

what are the symptoms?

depend on the area affected

- hearing loss

- facial paralysis

- swallowing difficulties

- muscle weakness