Fichas

Benign epithelial odontogenic tumors: types and features

nancy alsharu Inglés 56 fichas

it arrises from neoplastic transformation of dental lamina or epithelial rest of mallaisez

Fichas del conjunto (56)

1what are the 4 types of benign epithelial odontogenic tumor- ameloblastoma
-calcifying odntogenic tumor
-squamous odontogenic tumor
-OKC
2it arrises from neoplastic transformation of dental lamina or epithelial rest of mallaisezwhy is squamous odontogenic tumor is odontogenic
31) your patient is a young adult 2)its a rare tumor originates in pdl 3)clinically it appears as a painless swelling or loosening of teethclinical features of squamous odontogenic tumor
4Triangular unilocular radiolucency that doesnt exceed 1.5 cm ( look how its found in the alveolar process or the cervical part)RG of squamous odontogenic tumor
5can represent acanthamous ameloblastoma or scc (squamous cell carcinoma)what does squamous odontognic tumor represnt
hint: a type of ameloblastoma and a type of cell carcinoma
61-when u open inside the squamous cell lesion you will find in the microscope islands that are rounded and elongated of normal looking squamous epithelial cells 2- around these islands you will find fibrous CT 3-the peripheral cells will not have reversible nucleus or polirization 4- many epithelial celss have microcyst formationhistology of squamous odontogenic tumor
7local curettage and exo of involved toothhow do you treat squamous odontogenic tumor
8- ameloblastic fibroma -ameloblastic fibro-odontomahow many types of mixed odontogenic tumor do we have
9because both the epithelial cell and the mesenchymal cell ( mother cell or stem cell) are part of the neoplastic processwhy is ameloblastic fibroma a true biphasic ( happens in 2 phases) tumor ?
10fibroma is a benign tumor composed of fibrous CT ameloblastic: y3ni arrising from Dental lamina the purpose of this photo to show you what is a fibromaameloblastic fibroma
11its located on maxilla or mandible molar area over an unerupted toothlocation of ameloblastic tumor
12its slowly growing asymptomatic jaw expansion that targets young ageameloblastic fibroma does it
1) grow fast or slowly
2) is it painful or not painful
3) targets adults or young adults
13unilocular or multilocular radiolucency over an unerupted toothRG of ameloblastic fibroma
14anastamosing cords (x shape) of odontogenic epithelium which resembles dental lamina in the bell and cap stage of early odontogenesis no cyst formation the background consists of embryonic ct containing randomly oriented and widley seperated fibroblastremember shajaret el arz dr natheer mentioned its in the histology of ameloblastic fibroma describe it
15—zones that are surrounding the epithelial layer of ameloblastic fibroma are made of hylnization another name is called juxtaepithelial juxta means near to
16the lesion can be removed by enuculation meaning removing it from the bone crypt because the lesion is well encapsulatedhow do you treat ameloblastic fibroma
17ameloblastic fibroma has high recurrence rate because of the multiocular lesionafter you have enuculated ameloblastic fibroma is it going to come back is it recurent ?
18its a true neoplastic tumor similar exactly to ameloblastic fibroma but with the addition of dentin and enamelwhat does ameloblastic fibro-odontoma means
19its discovered accidently when theyre trying to do rg for delayed eruption its also asymptomatic just like ameloblastic fibromahow do you discover ameloblastic fibro-odontoma is it asymptomatic or symptomatic ???
20on the margin of thewell circumcribed lesion which can be uni or rarley multiocular radiolucent lesion usually located above impacted tooth you will find calcification (radio-opacity)rg of ameloblastic fibro-odontoma
21the soft tissue is similar to ameloblastic fibroma we have a calcified portion consist of a combined mass of enamel matrix and dentin matrix formation close to the epithelial structurehistology of ameloblastic odontogenic fibroma
22no it involves very conservative curretage where no bone invasion should happen recurrence is not possibleis the treatment of ameloblastic odontofibroma the same as ameloblastic fibroma ?
231- intraosseous or desmoplastic fibroma which is usually without odontogenic epithelium and quite rare 2- extraosseous which is common and odontogenic called peripheral odontogenic fibromawhat are the two types of central odontogenic fibroma
24contains widley scattered islands and strands of odontogenic epithelia and calcificationhistology of central odontogenic fibroma
25Small Lesion : well defined Unilocular RL Large Lesion: Multilocular with root resorption with occasional radiopaque fleck within the lesion.central odontogenic fibroma has 2 types of lesion small and large
describe their RG
26Treated by enucleation & vigorous curettage.how do you treat centeral odontogenic fibroma
27—peripheral odontogenic fibroma where is it derived from ?
is it extra osseous or intra osseous
the speed of its growth
is it clinically sessile ( with no neck) or peduncle (with neck)
where is its location on the gingiva labially or buccaly
is it on the mandible or maxilla
28fibrous ct interspected with less cellular myxoid (mucus) ct strands of scattered odontogenic epithelium with vaculizationhistology of peripheral odontogenic fibroma
29local excisionhow can you remove peripheral odontogenic fibroma
30- odontogenic fibroma ( peripheral and central) -cementoblastoma -odontogenic myxomawhat are the types of benign mesenchymal odontogenic tumor
31a local aggresive lesion intraosseous occurs in either jaw but in mandible it comes in place of missing tooth and in maxilla it erodes in sinusclinical view of odontogenic myxoma
32its slowly gorwing painless asymotomatic sometimes displaces teethspeed of odontogenic myxoma isit symptomatic and what does it do to the tooth
33multiocular radioluceny with soap bubble or honey comb pattern may contain thin residual bone which are at right angle to each otherdescribe the RG of odontogenic myxoma
34—histology of odontogenic myxoma
35—treatment of odontogenic myxoma
36pain but teeth are vitalthe most diagnostic feauture of cementoblastoma
37benign neoplasm of a cementum like tissue growing in continuity to the apical 1/3rd of the root of a vital molar or premolar that produces expansion and eventually painwhat is cementoblastoma
38osteoblastoma and osteoid osteoma2 histological features similar to cementoblastoma
39—RG of cementoblastoma
401) similar to osteoblastoma but with fusion to a vital tooth 2)deposition of unmineralized cementum fused with the normal mineralized cementum of the tooth root 3) the pdl around the normal cementum will mimic the bulbulous shape of the lesion 4) the peripheral zone is acellular while the central part is cellular loose more mineralized and very vascular also contains alot of multinucleated cells 5) the mineralized tissue contains many reverse lines as an indication of remodiling during growth of the lesionhistology ofcementoblastoma
41- well encapsulated lesion s encapsulated by a fibrous connective tissue capsule, which separated it from the host bone. so u can enucleate it easily with no recurrencetreatment of cemtoblastoma
42- rare neoplasm of odontogenic tumor 3 shapes - well circumbrcribed or solid or cystic lesion - resemble follicular ameloblatoma but with ghostcells and spherical calcification which is diagnostic for this lesion - location : areas anterior to the first molar - extraosseous: focal localized swelling on the gingiva -intraosseous: generalized expansion on b and lingual cortex with no paincalcifying odontogenic tumor or ghost cell cyst
43- associated with unerupted tooth most likley canine -uniocular radiolucency containing flecks of indistinct radioopacityrg of ghost cells
44- 2 types either with cystic center or solid which is neoplastic -the epithelial component similar to ameloblastoma -outer layer palasided columnar basal cells and inner is stellate reticulum Greatly enlarged eosinophilic keratinized , epithelial cells without visible nuclei referred to as "ghost cells" are present within the stellate reticulum-like area. Multiple spherical & diffuse calcification within the epithelia & C.T are also seen.histology of calcifying odontogenic tumor
45Cystic lesion by enucleation like a non-neoplastic cyst, whereas solid lesion may be more aggressive.treatment of calcifying odontogenic tumor
46Hamartomatous lesion found over unerupted teeth, containing enamel, dentin, pulp & cementum in either recognizable teeth shape (Compond) or as a solid mass ( complex). It represents nearly 70% of all odontogenic tumors. Most commonly occur in maxilla than in mandible as asymptomatic swelling. Detected radiographically during the first 2 decadesodontoma
47compund Commonly occur in anterior maxilla than in mandible as asymptomatic swelling either over the cowns of unerupted teeth or between the roots of erupted ones. Radiographically: Lesions are usually unilocular, containing multiple radiopaque structures that resemble miniature teeth. Compound odontoma may contains as few as 2-3 miniature tooth-like structures or as many 20-30.complex vs compound odontoma
48Found in posterior parts of mandible over impacted teeth & can attain sizes up to several centimeters. Appear as a solid radiopaque mass. Lesions are unilocular & separated from normal bone by distinct line of cortication. Individual tooth-like structures are absent.complex odontoma
49Histologically: Enamel, dentin & pulp tissue of the tooth-like structures of compound odontoma are arranged in an orderly pattern with a surrounding capsule. Complex odontoma differ by being composed of a single, disorganized mass of enamel, dentin & pulp with no recognizable tooth shapes.histology of compound vs complex
50enucleation from surrounding bonetreatment of compound vs complex
51Malignant Ameloblastoma: Tumour that shows the histopathologic features of benign ameloblastoma, both in primary tumor & in metastatic deposits. Ameloblastic carcinoma: Ameloblastoma that has cytologic features of malignancy in the primary tumor, in a recurrence or in any metastatic deposits. Both follow aggressive local course. Metastases from ameloblastoma mostly to the lung followed by cervical lymph nodesmalignant ameloblastoma and ameloblastic carcinoma
52Rare, affect patients over 50 years of age, mainly in mandible. pain, lip parasthesia & bony swelling are the CC. Soft tissue involvement in 60% of cases. Why? Uni or Multilocular RL with ill-defined margin.
53Histologically: It could be biphasic: Varying-sized nests of epithelial cells with clear or faintly eosinophilic cytoplasm . “similar to glycogen –rich presecretory ameloblasts”. Admixed with more eosinophilic polygonal epithelial cells. Or monophasic: Only clear cells arranged in nests and cores with thin hyalinized CT. Third pattern: Peripheral cells of the clear cells with palisading pattern, insignificant mitosis and pleomorphism Difficult to distinguish from intra osseous Mucoepidermoid carcinoma , CEOT, Metastatic renal cell carcinoma, clear cell breast carcinoma or clear cell melanoma.histolog of clear cell odontogenic carcinoma
54Treatment: initial enucleation or curretage to radical surgery Metastatic involvement of regional lymph nodes and pulmonary metastasis has been reported.txt of clear cell odontogenic carcinoma
55Aggressive & destructive intraosseus lesion of the mandible or maxilla that composed of poorly differentiated epithelial cells & clear cells in a pattern that is reminiscent of early odontogenesis. Radiographically: Diffuse honey-comb radiolucency. Histologically: Epithelial structures with malignant features are usually surrounded by zone of myxomatous connective tissue. Behavior: Very infiltrative & has a high recurrence rate.odontogenic carcinoma
56Malignant counterpart of AF or arise de novo Only mesenchyml portion shows features of malignancy Affects young males , mostly in the mandible as rapid clinical growth. Pain , swellin and rapid growth with Ill-defined destructive RL Microscopically: Epith. Components similar to that of AF Mesenchymal portion: Hyperchromatic, with bizzar pleomorphic cells & prominent mitosis Treatment: Radical Resectionameloblastic fibro sarcoma