SOFT TISSUE TUMORS*

Most common tumor of of oral cavity

Fibroma

Most common locations of fibromas

Buccal Mucosa > Labial mucosa, tongue and gingiva

Associated with flange of ill fitting denture

Epulis Fissuratum

epulis fissuratums are more common:

Max or mand

Anteiror or posterior

Female or male

Equal

Anterior

Female

Peripheral Ossifying fibromas are thought to arise from where?

PDL

Spindle cell proliferation with variable calcifications

Peripheral ossifying fibroma

Alveolar or gingiva mass in adults 40-50s

Peripheral Giant Cell Granuloma

Appearance of peripheral giant cell granuloma

Blueish red mass that may be ulcerated and cause cupping of underlying bone

Pyogenic Granuloma:

Appearance?

Common in who?

_____ easily?

Reddish mass

Children and young adults

Bleeds

What frequently occurs during pregnancy

Pyogenic Granuloma - Pregnancy epulis, granuloma gravidarum

Benign tumor of adipose tissue

Lipoma

Slow growing, non tender, soft, doughy, encapsulated

Lipoma

What color are lipomas?

Yellow - if close to surface

Uncommon reaction to sectioning of a nerve

Traumatic Neuroma

Where are traumatic neuromas common

Mental foramen

Tongue, buccal vestibule

May be tender of palpation

Traumatic Neuroma

Microscopically appears as a tangled mass of peripheral nerve fivers

Traumatic neuroma

Antoni A and Antoni B patterns

Intraosseous Schwannoma

Antoni A is characterized by what

What type of tumor

Palisaded nuclei arranged around varocay bodies

Intraosseous Schwannoma

Over ___% of neurofibromas are ______, and the remainder are ______ and associated with _________

90

Solitary

Multiple

Neurofibromatosis

Neurofibromatosis Skin Lesions (3)

Cafe au Lait Spot

Multiple Neurofibromas

Axiallary Freckling (Crowe sign)

The _____ variant of neurofibromatosis feels like a bag of worms

Plexiform

What is a crowe sign

Axillary freckling

What % of neurofibromatosis have potential malignant transformation

5

MEN1 most tumors are benign or malignant?

Benign

MEN 2a classification

MEN1 and medullary carcinoma of thyroid

MEN 2b classification

MEN2a and Neuromas

MEN Type 2B Triad

Medullary carcinoma of thyroid

Pheochromocytoma (adrenal medulla)

Mucosal neuromas

Bilateral comissural neuromas are characteristic of what

MEN Type 2B

Increased bp, young patient, long limbs, is characteristic of what

MEN Type 2B

Pheochromocytoma occur in __% of MEN Type 2B

What do they secrete?

What does this cause?

50

Catecholamines

Sweating, diarrhea, headaches, flushing, heart palpitations, HTN

Where are congential epulis found?

When?

Gender?

Benign or malignant?

Maxillary ridge of girl babies

Benign

Microscopic features of congenital epulis

Proliferation of cells with granular cytoplasms

Does congenital epulis have pseudoepitheliomatous hyperplasia?

Is it of neural origin?

No

No

Benign tumor like growth of infancy

When do they arise?

Have ______ endothelial growth

What ends up happening to them? By when?

Hemangioma

Within 8 weeks of birth

Rapid

Involution - 90% gone by 9 years

When are vascular malformations present?

Have _________ endothelial growth

How long do they last?

At birth

Normal

Persist through life

Hemangiomas are most common where?

Gender?

Ethnicity?

Head and neck (80%)

Females

Whites

Firm rubbery, red "stawberry" non blanching bosselated mass

Blue if deep

Hemangioma of infancy

___ flow venous malformations are variable size, compressible, blueish purple

Low

____ flow AterioVenous malformations have palpable thrill or bruit, skin is warm to touch, pain, bleeding, ulceration

High

Port wine stains are a type of what

Vascular malformation

Intrabony Venous or AV malformations:

More common in what gender?

Arch?

Female

Mandible

Asymp, soap bubble like multilocular radiolucency

Sunburst periosteal reaction

Cortical expansion are all characteristic of what

Intrabony vascular malformation

Encephalotrigeminal Angiomatosis is also known as what

Clinical apperance?

What else?

Sturge-Weber Syndrome

Port wine stain on distribution of 1st/2nd/3rd divison of CN V

Involvement of deeper soft tissues and meninges of brain

Radiographic finding of encephalotrigeminal angiomatosis

What causes this

Tram-line calcifications on skull film

Calcification of abnormal blood vessels

Benign neoplasm of lymphatic vessel differentiation

Lymphangioma

What is the most common intraoral site of lymphangioma

What does it look like?

Tongue

Vesicular apperance like frog eggs or tapioca pudding

Malignant Peripheral Nerve Sheath Tumors:

May arise _______ or in association with what

Spontaneously

Neurofibromatosis

Dil

What is the 5 year survival rate for malignant peripheral nerve sheath tumors with neurofibromatosis

10%

Histology of lymphangiomas

Dilated lymphatics just beneath surface epithelium

Rhabdomyosarcoma usually affects who

Children or adolescents

Relatively rare neoplasm of skeletal muscle differentiation

Rhabdomyosarcoma

Prognosis of Rhabdomyosarcoma depends on the _____ and _______

Stage and histopathological variant

Botryoid Rhabdomyosarcomas tend to happpen in who

Young female children

What is the most common sarcoma/malignancy in pediatric population in head and neck

Rhabdomyosarcoma (botryoid/embryonal)