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85 Cards in this Set
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Parenchyma
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Neoplastic tissue
it determines the biological behavior of the neoplasm. Closely resemble the tissue of origin |
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What are the two neoplastic tissue types of origin?
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Parenchyma--- it determines the biological behavior of the neoplasm. Closely resemble the tissue of origin
Stroma-- connective tissue, blood vessels, lymphatics |
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Stroma
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neoplastic tissue type of origin
connective tissue, blood vessels, lymphatics |
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What is epithelial dysplasia?
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a premalignant change with a reversible potential.
Contains enlarge and hyperchromatic nucleii. Increased mitotic figures, no basement membrane invasion |
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Is there any basement membrane invasion in epithelial dysplasia?
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no
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What is this...
A premalignant change reversible enlarged and hyperchromatic nucleii increased mitotic figures no basement membrane invasion |
Epithelial dysplasia
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90% of oral cancers have ______ lesions
60% have some _______ lesions Less than 3% are _______ |
90% of oral cancers have RED lesions
60% have some WHITE lesions Less than 3% are PURE WHITE |
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T or F Leukoplakis occurs 60x more frequently than erythroplakia but it far LESS ominous
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true
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Rate these in order of ominousness... hehe
White Red Speckled |
Red--erythoplakia
Speckled--leukoplakia White-- leukoplakia |
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What are the high risk sites for leukoplakia?
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1. floor of the mouth
2. Ventrolateral tongue 3. Lips |
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How long does it take for squamous cell carcinoma to develop?
a. 6 months b. 1 year c. 2 years d. 5 years e. 10 years |
d. 5 years
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Snuff Dippers Keratosis
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idiopathic leukoplakia
MB fold and gingiva White well-demarcated rough and wrinkled mucosa, gingival recession 10-30 years old, while blue collar males |
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Cigarette Smoking-Related Keratosis
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Idiopathic Leukoplakia
Flat or verruciform Middle aged males Buccal mucosa, MB fold and floor of the mouth Smooth white lesion to rough or verruciform |
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Nicotinic stomatitis is also called...
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Pipe and cigar smoking
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Pipe and Cigar smoking
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malignant potential, not well investigated
LIP cancer where the pipe is held |
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Nicotinic Stomatitis is a _____ change of both surface and ______ ductal epithelium
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Nicotinic Stomatitis is a BENIGN change of both surface and DUCTAL epithelium
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What does nicotinic stomatitis lead to?
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hyperkeratosis
acanthosis hyperplastic dilated salivary ducts |
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What does nicotinic stomatitis look like?
a. white b. red c. white and red |
c. white and red spot
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In erythroplakia, it is histologically....
49% _______ 51% ________ |
49% mild, moderate, severe dysplasis
51% invasive, squamous cell carcinoma |
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High risk sites for erythroplakia
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floor of the mouth
ventrolateral tongue soft palate complex |
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You have a red lesion
It has been determined that it is NOT a hemangioma What do you do? |
Highly likely to be premalignant or malignant...particularly true if smoker and lesion asymptomatic
MANAGE PROMPTLY |
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what is done for epithelial dysplasic/carcinoma in situ
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complete surgical removal with clean margins
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Melanoplakia
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pigmented patches on the oral mucous membrane
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What is carcinoma in situ?
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severe epithelial dysplasia FULL thickness of the epithelium with no invasion of the basement membrane
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Squamous epithelial tumors
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papilloma
squamous cell carcinoma verrucous carcinoma basal cell carcinoma carcinoma in situ |
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what are two differential diagnosis for PAPILLOMA?
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1. werruca vulvaris (common wart)
2. condyloma acuminatum (venereal wart) |
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Is papilloma a true tumor?
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Yes, of squamous epithelium
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Cauliflower like lesion
Squamous cell carcinoma Differential---common wart and venereal wart |
Papilloma
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What is the most common malignancy of the oral cavity?
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Squamous Cell Carcinoma
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How fatal is squamous cell carinoma?
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50% at 5 years
75% at 10 years In success, often disfiguring |
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Most common places for Squamous cell carcinoma is ...
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tongue, lateral and ventral
then oropharynx, floor of the mouth and lips Seen is males 55 years + |
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T or F The most common presentation of squamous cell carcinoma is a non healing ulcer
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yes
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Signs and symptoms of SCC
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changes in denture fit
trismus decreased tongue mobilitiy referred otalgia loose teeth mimicking severe perio |
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This is squamous cell carcinoma seen on the lips
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solar keratosis
tobacco use |
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Where is SCC most aggressive?
a. lateral anterior surfaces of the tongue b. ventral anterior surfaces of the tongue c. Posterior base of the tongue |
c. Posterior base of the tongue
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T or F 5 year survival rate for SCC is BELOW 35%
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true
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SCC is likely to metastasize to regional lymph nodes when it is seen at the base of the tongue
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TRUE, 78% do
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What is the main risk factor for floor of the mouth SCC?
a. smoking b. diabetes c. alcohol d. unknown |
a. smoking
indurated ulcer, often anterior floor of the mouth or can be red, white or mixed. |
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How do you treat floor of the mouth SCC?
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surgery
radiation or alone (because of anatomy of area) Poor prognosis if metastasis |
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You find SCC on the buccal mucosa. How likely is that?
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less than 3% of the all OSCC
Probbaly from tobacco and chewing betel Treat with surgery and radiation 5 year survival 28-50% |
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How does oral squamous cell CA start?
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DNA damage
Point mutations leading to changes in irreversible transformation of epithelial cells |
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Over 80% of SCC patients are ____ users
a. marijuanna b. tobacco c. alcohol ab (users) d. |
b. tobacco
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T or F Cirrhosis of the liver may significantly affect the risk of oral cancers
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true
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The following are risk factors for oral cancer
a. sun exposure b. lichen planus c. viruses (HPV, herpes) d. diet |
YES all
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Tis
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carcinoma in situ
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T1
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tumor is 2 cm or less in greatest dimension
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T2
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tumor between 2-4 cm
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T3
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greater than 4 cm in greatest dimension
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What is T?
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primary tumor
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What is N?
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Regional Lymph Node
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N0
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no clinically palpable cervical lymph node but metastasis NOT suspected
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N1
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palpable homolateral lymph nodes but NOT fixed, metastasis SUSPECTED
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N2
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Palpable contra or bilateral lymph nodes, not fixed, metastasis suspected
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N3
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palpable and fixed lymph node, metastasis suspected
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What is M?
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Distant metastasis
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M0
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no metastasis
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M1
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Metastasis other than lymph nodes
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What do oral cancer patients mainly die from?
a. infection from lower resistance b. hemorrhage if tumor erodes the main blood vessels c. reduced organ function |
A and B
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T or F Tumors near or crossing midline have worse prognosis from greater likelihood of bilateral node involvement
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True
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After radiation therapy, the patient will haev compromised vascular bed in bone. Why is this significant?
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We need to avoid vasoconstrictors
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Patients undergoing radiation therapy and currently taking bisphosphonates should do WHAT (fosfomax)
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STOP 3 months prior to extractinos and 3 months after.
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The different forms of salivary gland pathology
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Reactive
Obstructive Infectious Autoimmune Neoplastic |
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Major salivary gland
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palate
parotid anywhere there is a salivary gland |
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Pleomorphic Salivary Gland tumor AKA
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Benign Mixed tumors
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What is the most common malignant salivary tumor in children?
a. Pleomorphic Ademona b. adenoid cystic carcnimona c. Mucoepidermoid Carcinoma |
c. Mucoepidermoid Carcinoma
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Which of the following does NOT feature an unencapsulated lesion?
a. adenoid cystic carcinoma b. Warthin's tumor c. mucoepidermoid carcinoma |
b. Warthin's tumor, both mucoepidermoid and adenoid cystic carcinoma are NOT encapsulated.
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Which is from a possible metasisis of an ignore dentigerous cyst?
a. Odontogenic myeoma b. mucoepidermoid carcinoma c. odontoma d. ameloblastic fibroma |
b. mucoepidermoid carcinoma
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Which of the following is a SKIN tumor associated with ROLLED borders and sun exposure
a. Warton's tumor b. Squamous Cell Carcinoma c. mucoepidermoid carcinoma d. basal cell carcinoma |
d. basal cell carcinoma
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Which of the following is most often associated with PAIN
a. adenoid cystic carcinoma b. mucoepidermoid carcinoma c. basal cell carcinoma d. Warton's tumor |
a. adenoid cystic carcinoma
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T or F Salivary tumors are typically slow growing
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true
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Which of the following is NOT a tumor of salivary epithelial origin?
a. calclfying epithelial odontogenic b. monomorphic ademona c. adenoid cystic carcinoma d. pleomorphic adenoma |
a. calclfying epithelial odontogenic
however, it is epithelial based, it is of ODONTOGENIC origin |
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Which of the follow are tumors of connective tissues and which are epithelium?
a. ameloblastoma b. cementifying and ossifying fibroma c. calcifying epithelial odontogenic d. cementoblastoma e. odontogenic myoma |
a. ameloblastoma (E)
b. cementifying and ossifying fibroma (CT) c. calcifying epithelial odontogenic (E) d. cementoblastoma (CT) e. odontogenic myoma (CT) |
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What has the thickest capsule of any benign lesion?
a. adenamatoid odontogenic tumor b. ameloblastic carcinoma c. adenoid cystic carcinoma d. warton's tumor |
a. adenamatoid odontogenic tumor
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This lesion presents as radiolucencies with flecks of calcificiation, associated with impacted teeth and tends to most often be in anterior maxilla and females. Epithelium and CT involvement
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Adenomatoid Odontogenic Tumor
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This lesion is associated with impacted teeth, has radio opaqueness within radio L, of epithelial origin and is a rare slow growing neoplasm
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calcifying epithelial odontogenic tumor
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This odontogenic neoplasm is of epithelial origin, seen most often in mandible molar ramus area, associated with dentigerous cysts and slow growing, unencapsulated. From remnants of the dentinal lamina
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ameloblastoma
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This lesion is not typically a true tumor (unless in solid form), uni locular or multi locular, calcifications present. Non aggressive and is treated with enucleation.
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Calcifiying Odontogenic Cyst
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This tumor is of CT, odontogenic origin. Displays as a radiolucency, poorly defined, causes tooth displacement, honeycombed look, usually in the mandible and is a NON encapsulated lesion.
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Odontogenic Myxoma
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Which tumor requires enucleation AND tooth removal because of the neoplasm's unique ability to fuse to hard tissues?
a. Cemento-osseous dysplasia b. Cementoblastoma c. Adenomatioid odontogenic tumor d. Cementifying fibromas |
b. Cementoblastoma
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This tumor causes:
Pain, RO mass at apex of teeth with a RL halo, fuses with dental hard tissues, and seen most often in young adults. Derived from CT |
cementoblastoma
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What is the most common odontogenic tumor?
a. ameloblastoma b. odontogenic myxoma c. ameldoblastic fibroma d. odotoma |
d. odontoma
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This tumor:
contains enamel, dentin, cementum and pulp tissue, can clinically manifest as failure of tooth to erupt. |
Odontoma
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This tumor calls for excision and thorough scaling of the adjacent teeth.
a. cementoblastoma b.peripheral ossifying fibroma c. peripheral ameloblastoma d. odontoma |
b. peripheral ossifying fibroma
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T or F Cemento-osseous dysplasia and calcifying odontogenic cyst are both NOT true tumors
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True
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what is the difference between sarcoma and carcinoma?
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carcinoma--originated epithelium
sarcoma-- originates CT |
