2 Lec 7 (Exam2): Benign Soft Tissue Tumors

Fibroma

what is the MOST common soft tissue tumor?

densely collagenized fibrous connective tissue

what is the histopathologic presentation of fibromas?

false

t/f: fibromas are true neoplasms

Fibroma

ID the pathology:

-Reactive hyperplasia of fibrous connective tissue

-Results from chronic low-grade irritation

chronic low-grade irritation

what is normally the cause of fibromas?

Fibroma

patient presents with a pink nodule on the buccal mucosa. Patient claims they have always bitten their cheek and started to notice a "bump" forming near the same area. What could this be?

conservative excision

treatment for fibromas:

neoplasia

what needs to be ruled out when diagnosing a fibroma?

Giant Cell Fibroma

patient presents with an asymptomatic nodule with papillary surface on the anterior dorsal tongue. Histopathologic features show vascular fibrous connective tissue , numerous large stellate fibroblasts that contain several nuclei and rete ridges narrow and elongated. What do you suspect?

Giant Cell Fibroma

vascular fibrous connective tissue , numerous large stellate fibroblasts that contain several nuclei and rete ridges narrow and elongated. This is associated with what pathology?

conservative excision

treatment for Giant Cell Fibromas:

gingiva

what ONLY location do peripheral giant cell granuloma present on?

gingiva

what ONLY location do peripheral ossifying fibroma present on?

Lobular capillary hemangioma

pregnancy tumor

what are two other names for Pyogenic Granuloma?

neither pyogenic nor a granuloma

why is Pyogenic Granuloma a poor name for the entity?

Pyogenic Granuloma

male patient presents with red-pink ulcerated nodule on the facial aspect of the maxillary gingiva. Histopathology shows vascular proliferation of granulation tissue. What do you suspect?

Pyogenic Granuloma

Vascular proliferation of granulation tissue is associated with what pathology?

gingiva

75% of Pyogenic Granulomas present of what location?

conservative excision

eliminate irritants

what is the treatment for Pyogenic Granulomas?

Peripheral Giant Cell Granuloma (PGCG)

patient presents with a purplish, slightly ulcerated nodule on the facial aspect of the maxillary gingiva. Histopathologic features show Multinucleated giant cells with up to several dozen nuclei, hemorrhage and hemosiderin. What do you suspect?

Peripheral Giant Cell Granuloma (PGCG)

Multinucleated giant cells with up to several dozen nuclei, hemorrhage and hemosiderin is associated with what pathology?

local excision down to bone

what is the treatment for Peripheral Giant Cell Granuloma (PGCG)?

Peripheral Ossifying Fibroma

patient presents with pink nodule on the facial aspect of the mandibular gingiva. Histopathology shows fibrous proliferation with formation of mineralized (osseous) product. What do you suspect?

Peripheral Ossifying Fibroma

fibrous proliferation with formation of mineralized (osseous) product is associated with what pathology?

Lipoma

what is the most common mesenchymal neoplasm?

Lipoma

-Benign tumor of adipose tissue

-Most common mesenchymal neoplasm

-Pink or yellow in color

Lipomatous

Neural

Vascular*

Myofibroblastic

Muscular

name 5 types of benign soft tissue neoplastic tumors:

Lipoma

patient presents with nodule on the floor of the mouth that is and slight yellowish tint. Histopathology showed Well-circumscribed mature adipose tissue. What do you suspect?

Lipoma

ID the pathology:

conservative excision

what is the treatment for a Lipoma?

dorsal tongue

what is the most common site presentation for a Granular Cell Tumor?

Granular Cell Tumor

Patient presents with a yellowish growth on the dorsolateral tongue surface. Histopathology showed Abundant pale, eosinophilic granular cytoplasm and pseudoepitheliomatous hyperplasia. What do you suspect?

Granular Cell Tumor

Abundant pale, eosinophilic granular cytoplasm and pseudoepitheliomatous hyperplasia is associated with what pathology?

Giant Cell Fibroma

which of the following is NOT associated with presenting yellow?

-Granular cell tumor

-Neurofibroma

-Giant Cell Fibroma

-Schwannoma

-Palisaded encapsulated neuroma

-Traumatic neuroma

-Lipoma

Congenital Epulis

3 week old female patient presents with a nodular formation on the maxillary gingiva lateral to the midline. Histopathology showed cells with granular cytoplasm resemble granular cell tumors. NO pseudoepitheliomatous hyperplasia were present. What do you suspect?

Congenital Epulis

granular cytoplasm with NO pseudoepitheliomatous hyperplasia is associated with what pathology?

Congenital Epulis

-Rare non-neural soft tissue tumor occurring on alveolar ridge of newborns:

Congenital Epulis

This oral pathology resembles granular cell tumor microscopically:

female

Congenital Epulis as a 90% predilection for what gender?

Surgical excision or

Complete regression over time

treatment for Congenital Epulis?

Granular cell tumor

Congenital Epulis

What two oral pathologies histologically will present with eosinophilic granular cytoplasm?

Neurofibroma

What is the most common peripheral nerve tumor?

Neurofibromatosis

Patients that present with multiple neurofibromas must be investigated for what condition?

Neurofibroma

Patient presents with yellowish nodule on the dorsal tongue and gingiva. Histopathology shows interlacing bundles of spindle-cells with wavy nuclei. Patient also has several nodules all over the body that vary in size. What do you suspect the oral presentations to be?

Neurofibroma

interlacing bundles of spindle-cells with wavy nuclei is associated with what pathology?

local surgical excision

treatment for Neurofibroma:

Type I/von Recklinghausen Disease

of the 8 forms of neurofibromatosis, what type is the most common?

Neurofibromatosis

"Café au lait" pigmentation (smooth-edged cutaneous macules) are associated with ______

Neurofibromatosis

Crowe sign (axillary freckling) is associated with ______

Neurofibromatosis

Lisch Nodules (brown pigmentation on iris) are associated with ______

Schwannoma

Patient presents with small yellow papule on dorsal tongue. Histopathology shows microscopic circumscription and Antoni A and Antoni B histopathologic patterns. What do you suspect the oral presentation to be?

Multiple Endocrine Neoplasia

Patient presents with large nodule on the roof of the mouth. Patient recalls accidentally biting hard onto a fish bone that perforated the palatal mucosa. Biopsy reveals it to a neuroma. Patient returns to office after 7 months and a 2nd similar nodule has developed. What must the patient be worked up for?

Multiple Endocrine Neoplasia (MEN) Type 2B

Patient presents with multiple nodules on the surface of the tongue (later found to be neuromas). Patient was recently diagnosed with medullary carcinoma of the thyroid (MTC), pheochromocytomas of adrenal medulla, and parathyroid hyperplasia. Mucosal neuromas on eyelid are also present. What is the diagnosis?

Multiple Endocrine Neoplasia (MEN) Type 2B

mutation of RET protooncogene is associated with _______

Multiple Endocrine Neoplasia Type 2 (A/B)

Familial medullary thyroid carcinoma syndrome is associated with _______

Multiple Endocrine Neoplasia Type 2 (A/B)

Pheochromocytomas is associated with _____

Multiple Endocrine Neoplasia (MEN) Type 2A

Patient was recently diagnosed with medullary carcinoma of the thyroid (MTC), pheochromocytomas of adrenal medulla, and parathyroid hyperplasia. No oral neuromas are present. What is the diagnosis?

Medullary carcinoma of the thyroid

elevated serum or urinary levels of calcitonin is associated with what condition?

Pheochromocytomas

urinary vanillylmandelic acid (VMA) and increased epinephrine:norepinephrine is associated with what condition?

Early recognition of oral features

Prophylactic removal of thyroid gland

Monitor for pheochromocytomas

treatment for Multiple Endocrine Neoplasia (MEN) Type 2B:

Arteriovenous

All of the following are Vascular neoplasms EXCPET one:

•Hemangioma of infancy

•Congenital hemangioma

•Kaposiform hemangioendothelioma

•Tufted angioma

•Arteriovenous

Tufted angioma

All of the following are Vascular developmental malformations EXCPET one:

•Capillary

•Tufted angioma

•Venous

•Lymphatic

•Arteriovenous

Vascular neoplasms

Hemangioma of infancy is what type of vascular anomaly?

Vascular neoplasms

Congenital hemangioma is what type of vascular anomaly?

Vascular neoplasms

Kaposiform hemangioendothelioma is what type of vascular anomaly?

Vascular neoplasms

Tufted angioma is what type of vascular anomaly?

Vascular developmental malformations

Capillary type is what type of vascular anomaly?

Vascular developmental malformations

Venous type is what type of vascular anomaly?

Vascular developmental malformations

Lymphatics type is what type of vascular anomaly?

Vascular developmental malformations

Arteriovenous type is what type of vascular anomaly?

Hemangioma of Infancy

What is the most common tumor of children?

Hemangioma of Infancy

1 year old female patient presents with purple nodule on the surface of the skin lateral to the nose. Her parents noted that it came out of nowhere when she was about 4 weeks old and grew very fast, but has since started to shrink. What is the diagnosis?

true

t/f: Hemangioma of Infancy is a type of neoplasm

false

t/f: Vascular malformations are a type of neoplasm

Vascular developmental malformations

Patient presents with a dark purple, port-wine stain macule on the buccal mucosa. Patient claims that is has been there all his life, it was present when he was born. What is the diagnosis?

Vascular developmental malformations

this type of vascular condition that affects infants is present at birth:

Myofibroma

•Rare myofibroblastic neoplasm

•Most common in mandible, but peripheral lesions often develop

conservative excision

treatment for Myofibroma:

Hemangioma of Infancy

this type of vascular condition that affects infants is rarely present at birth:

muscular

Leiomyoma (Vascular leiomyoma) and Rhabdomyoma in the oral cavity are rare types of ______ neoplasms