Oral Benign Soft Tissue Mesenchymal Lesions

what is the mnemonic used to determine the need for biopsy?

ABCDE

A = asymmetry

B = border

C = color

D = diameter

E = evolution

is the prognosis of melanoma worse for melanoma on the skin or melanoma in the oral cavity?

melanoma in the oral cavity is worse

what is a satellite lesion?

a lesion that appears to be on it's own from another lesion

the mesenchyme is (above/below) the basement membrane

below

what is a traumatic fibroma (focal fibrous hyperplasia)?

hyperplasia in response to low-grade biting

it's connective tissue is composed of excessive collagen

what is the most common site for a traumatic fibroma?

buccal mucosa

it can be on any site that is exposed to trauma

describe how a traumatic fibroma looks/feels clinically:

pink, firm on palpation, painless

it also has a smooth surface

what is a giant cell fibroma?

a smooth surfaced, pink papule that is characterized by unusual fibroblasts

the collagen is often "whorling" or "hyalinized"

what are retrocuspid papillae?

a normal anatomic variant that appear as bumps on the back on the mandibular canines

they will also be bilateral

lipomas are (common/rare) in the oral cavity

rare

describe how a lipoma would look/feel clinically:

light yellow, soft to palpation, smooth surface

they are non-ulcerated and painless

where are lipomas found most commonly in the oral cavity?

buccal mucosa

describe how a granular cell tumor would look/feel clinically:

yellowish, raised, firm to palpation, non-ulcerated lesion

this is painless

where is the most common site in the oral cavity for a granular cell tumor?

tongue

what is the most distinctive microscopic feature of a granular cell tumor?

pseudoepitheliomatous hyperplasia (PEH)

this can be mistaken for squamous cell carcinoma

what is the treatment for a granular cell tumor?

excisional biopsy - you can cut at the deep margin and they will still not recur

what is congenital epulis of the newborn?

proliferation of granular cells that appears as a soft, round, exophytic mass attached to the alveolar mucosa

congenital epulis is more common in (males/females)

females

congenital epulis is more common on the (maxilla/mandible)

maxilla

T/F: pseudoepitheliomatous hyperplasia (PEH) is found in congenital epulis

false

it is found in a granular cell tumor

what is a neurofibroma?

benign tumor of Schwann cell origin, most common on the tongue or the palate

they are painless and non-ulcerated

describe how a neurofibroma would look/feel clinically:

smooth surface, non-ulcerated

neurofibromatosis can also be called __________

von Recklinghausen's disease

T/F: patients with neurofibromatosis may die of sarcomas

true

what is neurilemmoma?

benign tumor of Schwann cell origin that is a smooth surfaced, pink nodule

Verocay bodies are indicative of what lesion?

neurilemmoma

is there a better prognosis for neurofibroma or neurilemmoma?

neurilemmoma

what is multiple endocrine neoplasia syndrome III? (MEN III)

characterized by:

1. multiple neuromas

2. pheochromocytoma

3. medullary carcinoma of the thyroid

you can save a patients life if you detect this

what is a hemangioma?

benign tumor/hyperplasia of blood vessels (congenital)

what is a lymphangioma?

benign tumor/hyperplasia of lymphatic vessels

what is cystic hygroma?

a congenital defect that produces a benign mass in the head/neck that presses on trachea of the newborn

what is a peripheral giant cell granuloma?

large reddish/purple benign lesion that contain multinucleated giant cells and fibroblasts

what is a peripheral ossifying fibroma?

benign lesion where bone proliferates from a reaction to plaque and calculus

extraction of surrounding teeth may be necessary when these are present

are people of color protected from melanoma of the skin by virtue of their natural pigmentation?

yes

are people of color protected from melanoma of the oral cavity by virtue of their natural pigmentation?

no

are nerve elements found in or adjacent to the lesion in neurofibroma?

in the lesion

are nerve elements found in or adjacent to the lesion in neurilimmoma?

adjacent to the lesion

describe how a traumatic fibroma looks/feels clinically: