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PATH-Neoplasia
Soft Tissue, Bone, Blood Forming Tissues
| Question | Answer |
|---|---|
| tumors of soft tissue | lipoma (fat/adipose) tumors of nerve tissue tumors of muscle vascular tumors (blood/lymphatics) |
| lipoma | benign tumor of mature fat cells >occur over 40 intraorally most common- buccal mucosa and vestibule |
| how does lipoma microscopically? | well delineated tumor w/ mature fat cells uniform in size and shape |
| tx of lipoma | surgical excision |
| name tumors of never tissue | neurofibroma (von Recklinghausen disease) schwannoma granular cell tumor congenital epulis |
| neurofibroma and schwannoma | benign tumors derived from Schwann cell (schwann cells component of CT surrounding nerve) most common intraoral-tongue |
| how does neruofibroma and schwannoma appear microscopically? | neurofibroma (von Recklinghausen) -well delineated, diffuse proliferation of spindle shaped schwann cells schwannoma -spindle shaped schwann cells arranged in palisaded whorls around pink zone, surrounded by CT capsule |
| tx for neurofibroma and schwannoma | surgical excision |
| granular cell tumor | benign tumor composed of large cells w/ granular cytoplasm >often occurs tongue, then buccal mucosa painless nonnulcerated nodule found in adults w/ female sex predilection |
| how does granular cell tumor appear microscopically? | large oval shaped w/ granular cytoplasm |
| tx of granular cull tumor | surgical excision |
| congenital epulis | benign neoplasm composed of cells closely resembling those seen in granular cell tumor present @ birth sessile or pedunculated mass on gingiva occurs anteriors of max. gingiva |
| tx of congenital epulis | surgical excision |
| name tumors of muscle | rhabdomyoma leiomyoma rhabdomyosarcoma |
| tx of tumors of muscle? or just rhabdomyosarcoma? | multidrug chemotherapy, radiation therapy, surgery poor Px |
| rhabdomyoma | benign tumor of striated muscle |
| leiomyoma | benign tumor of smooth muscle |
| rhabdomyosarcoma | malignant tumor of striated muscle *most common malignant soft tiuss. tumor of head and neck in children |
| name vascular tumors | hemangioma lymphangioma malignant vascular tumors |
| hemangioma | benign proliferation of capillaries capillary hemangioma-contains numerous small capillaries cavernous hemangioma-contains larger blood vessels most present @ brith or short after >50% occur in head/neck area most common-tongue > common in females |
| tx of hemangioma | many undergo spontaneous remission surgery or injection of sclerosing solution |
| lymphangioma | benign tumor of lymphatic vessels most present @ birth 50% arise in head/neck area most common location- tongue (looks ill defined mass w/ pebbly surface) |
| tx of lymphangioma | surgical excision tends to reoccur |
| name malignant vascular tumors | angiosarcoma, kaposi sarcoma, kaposi sarcoma+HIV |
| angiosarcoma | |
| kaposi sarcoma | skin, oral mucosa, historically seen in older men, more aggressive form arisen w/ HIV |
| kaposi sarcoma+HIV | lesions- purple macules, plaques, exophytic tumors most common- hard palate, gingiva may also occur in immunodeficent pts caused by HHV8 |
| tx of kaposi sarcoma HHV8 | surgical excision, radiation therapy, or combo |
| name tumors of melanin producing cells | melanotic nevi malignant melanoma |
| melanotic nevi | developmental tumor of melanocytes or pigmented congenital lesion arises on skin or oral mucosa most often-hard palate or buccal mucosa 2xs in females than males id. in individuals 20-50yrs old |
| tx of melantic nevi | biopsy surgical excision reoccurence rare |
| name tumors of bone and cartilage | torur exotosis osteoma osteosarcoma tumors of cartilage |
| torus | benign lesino composed of normal compact bone located- midline of palate, lingual aspects of manidble area of premolars |
| exotosis | small nodular excrescence of nomal compact bone lcated-buccal aspect of max. and man. alveolar ridges |
| osteoma | asymptomatic benign tumor composed of benign compact bone component of Gardner syndrome |
| how does osteoma appear radiographically? | either sharply radioopaque mass w/in bone or attached to outer surface of bone |
| tx of osteoma | surgical excision doesn't reoccur |
| osteosarcoma | malignant tumor of bone-forming tiss. *most common primary malignant tumor of bone in pt <40yrs old (ave. age 37_ 2xs frequent in mandible > in males diffuse swelling or mass, painful paresthesia common when mandible involved |
| how does osteosarcoma appear radiographically? | r/l or r/o destructive poorly defined lesion can involve adjacent soft tiss. "sunburst" pattern, asymmetric widening of pdl space |
| tx of osteosarcoma | preoperative multiagent chemotherapy followed by surgery jaw tumors reoccur |
| tumors of cartilage | >malignant than benign >males than females |
| tx of chondrosarcomas | wide surgical excision poor Px |
| chondroma-tumors of cartilage | benign tumor of cartilage |
| chondrosarcoma-tumors of cartilage | malignant tumor of cartilage may occur max. or man. |
| name tumors of blood-forming tissues | leukemia lymphoma multiple myeloma |
| leukemia | overproduction of atypical WBC types classified according to cells that are proliferating: myelocytes, lymphocytes, monocytes >males than females |
| tx of leukemia | chemotherapy, radiation therapy, corticosteriods Px depends on type of extent of disease |
| acute leukemia | > in kids + young adults proliferation of immature WBC |
| chronic leukemia | occurs middle-aged adults excess proliferation of mature WBC |
| monocyte leukemia | most often exhibits oral lesions commonly see diffure gingival enlargment w/ persistent bleeding |
| lymphoma | malignant male adults lymph node invovlment base of tongue, pharynx, soft palate (tonsillar area) |
| tx for lymphoma | radiation, chemo, surgery or combo |
| Non-Hodgkin's lymphoma | malignant tumor of lymphoid tiss. gradual enlargement of lymph nodes most common-tonsils > in adult, males |
| tx of Non-hodgkin's lymphoma | radiotherapy, surgery, chemotherapy, or combo |
| multiple myeloma | systematic malignant proliferation of plasma cell destructive lesions in bone most pts >40yrs, males, 7th decade of life bone pain and swelling *elevation on single immunoglobulin- monoclonal spike |
| how does multiple myeloma appear radiographically? | multiple radiolucent lesions mandible affects > max. |
| tx of multiple myeloma | chemotherapy and radiation poor Px |
| metastatic tumors of jaws | arise from thyroid, breast, lungs, prostate gland, kidneys most common-mandible painful, paresthesia, swelling, expansion of affcected bone, loosening of teeth in affected area most pt. adults, males |
| (T/F) complications may be caused only indirectly to anticancer therapy | False. may be caused directly or indirectly |
| (T/F) complications can be acute or chronic | True. |
| (T/F) Preventive measures can't be taken before anticancer therapy begins to lessen or prevent oral complications | False. Measures can be taken |
| name radiation and chemotherapy side effects | mucositis dysgusia xerostomia pain malnutrition dehydration change in dental growth (kids tooth decay gum disease |
| what types of changes can chemotherapy and radiation cause to the oral cavity? | lining of mouth, saliva production, upset healthy balance of bacteria -these changes can lead to mouth sores, infection, tooth decay |
| side effects of chemotherapy | reduce # WBC, weakens immune sys., easier to develop infection, acute complications |
| side effects of radiation therapy | direct damage to oral tiss., salivary glands, bone acute complications can cause permanent tiss. damage pt then at risk for life-long complications common oral complications: xerostomia, tooth decay, infection, dysgusia, loss of function |
| preventive measures: | eating well-balanced diet learning how to care for oral cavity during/after anticancer therapy have complete OH exam w/ dentist who is familiar w/ side effects |
| preventive oral health exam, checking for: | mouth sores/infection tooth decay gun disease ill fitting dentures TMJ issues problems w/ salivary glands |
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