Soft Tissue, Bone, Blood Forming Tissues
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| tumors of soft tissue | lipoma (fat/adipose)
tumors of nerve tissue
tumors of muscle
vascular tumors (blood/lymphatics)
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| lipoma | benign tumor of mature fat cells
>occur over 40
intraorally most common- buccal mucosa and vestibule
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| how does lipoma microscopically? | well delineated tumor w/ mature fat cells uniform in size and shape
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| tx of lipoma | surgical excision
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| name tumors of never tissue | neurofibroma (von Recklinghausen disease)
schwannoma
granular cell tumor
congenital epulis
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| neurofibroma and schwannoma | benign tumors derived from Schwann cell
(schwann cells component of CT surrounding nerve)
most common intraoral-tongue
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| 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
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| tx for neurofibroma and schwannoma | surgical excision
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| 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
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| how does granular cell tumor appear microscopically? | large oval shaped w/ granular cytoplasm
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| tx of granular cull tumor | surgical excision
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| 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
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| tx of congenital epulis | surgical excision
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| name tumors of muscle | rhabdomyoma
leiomyoma
rhabdomyosarcoma
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| tx of tumors of muscle? or just rhabdomyosarcoma? | multidrug chemotherapy, radiation therapy, surgery
poor Px
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| rhabdomyoma | benign tumor of striated muscle
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| leiomyoma | benign tumor of smooth muscle
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| rhabdomyosarcoma | malignant tumor of striated muscle
*most common malignant soft tiuss. tumor of head and neck in children
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| name vascular tumors | hemangioma
lymphangioma
malignant vascular tumors
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| 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
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| tx of hemangioma | many undergo spontaneous remission
surgery or injection of sclerosing solution
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| 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)
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| tx of lymphangioma | surgical excision
tends to reoccur
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| name malignant vascular tumors | angiosarcoma,
kaposi sarcoma,
kaposi sarcoma+HIV
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| angiosarcoma |
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| kaposi sarcoma | skin, oral mucosa, historically seen in older men, more aggressive form arisen w/ HIV
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| kaposi sarcoma+HIV | lesions- purple macules, plaques, exophytic tumors
most common- hard palate, gingiva
may also occur in immunodeficent pts
caused by HHV8
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| tx of kaposi sarcoma HHV8 | surgical excision, radiation therapy, or combo
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| name tumors of melanin producing cells | melanotic nevi
malignant melanoma
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| 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
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| tx of melantic nevi | biopsy
surgical excision
reoccurence rare
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| name tumors of bone and cartilage | torur
exotosis
osteoma
osteosarcoma
tumors of cartilage
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| torus | benign lesino composed of normal compact bone
located- midline of palate, lingual aspects of manidble area of premolars
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| exotosis | small nodular excrescence of nomal compact bone
lcated-buccal aspect of max. and man. alveolar ridges
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| osteoma | asymptomatic benign tumor composed of benign compact bone
component of Gardner syndrome
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| how does osteoma appear radiographically? | either sharply radioopaque mass w/in bone or attached to outer surface of bone
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| tx of osteoma | surgical excision
doesn't reoccur
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| 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
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| 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
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| tx of osteosarcoma | preoperative multiagent chemotherapy followed by surgery
jaw tumors reoccur
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| tumors of cartilage | >malignant than benign
>males than females
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| tx of chondrosarcomas | wide surgical excision
poor Px
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| chondroma-tumors of cartilage | benign tumor of cartilage
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| chondrosarcoma-tumors of cartilage | malignant tumor of cartilage
may occur max. or man.
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| name tumors of blood-forming tissues | leukemia
lymphoma
multiple myeloma
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| leukemia | overproduction of atypical WBC
types classified according to cells that are proliferating: myelocytes, lymphocytes, monocytes
>males than females
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| tx of leukemia | chemotherapy, radiation therapy, corticosteriods
Px depends on type of extent of disease
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| acute leukemia | > in kids + young adults
proliferation of immature WBC
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| chronic leukemia | occurs middle-aged adults
excess proliferation of mature WBC
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| monocyte leukemia | most often exhibits oral lesions
commonly see diffure gingival enlargment w/ persistent bleeding
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| lymphoma | malignant
male adults
lymph node invovlment
base of tongue, pharynx, soft palate (tonsillar area)
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| tx for lymphoma | radiation, chemo, surgery or combo
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| Non-Hodgkin's lymphoma | malignant tumor of lymphoid tiss.
gradual enlargement of lymph nodes
most common-tonsils
> in adult, males
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| tx of Non-hodgkin's lymphoma | radiotherapy, surgery, chemotherapy, or combo
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| 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
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| how does multiple myeloma appear radiographically? | multiple radiolucent lesions
mandible affects > max.
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| tx of multiple myeloma | chemotherapy and radiation
poor Px
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| 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
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| (T/F) complications may be caused only indirectly to anticancer therapy | False. may be caused directly or indirectly
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| (T/F) complications can be acute or chronic | True.
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| (T/F) Preventive measures can't be taken before anticancer therapy begins to lessen or prevent oral complications | False. Measures can be taken
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| name radiation and chemotherapy side effects | mucositis
dysgusia
xerostomia
pain
malnutrition
dehydration
change in dental growth (kids
tooth decay
gum disease
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| 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
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| side effects of chemotherapy | reduce # WBC, weakens immune sys., easier to develop infection, acute complications
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| 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
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| 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
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| 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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