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HHD
HUMAN DISEASES
Oral Facial & Bone Neoplasms
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What is
neoplasia
?
New growth
What is a neoplasm?
An abnormal growth that exceeds normal tissue
It is uncoordinated & persists after the cessation of the stimulus that caused it
How do we differentiate neoplasia?
Into
benign
and
malignant.
How do benign and malignant neoplasms look?
In
malignant
neoplasms, rate of division of cells is v
high
so it outstrips its
blood
supply. This causes
starvation
of blood =
Necrosis
What are some examples of benign oral neoplasia?
Haemangioma
Lipoma
Fibroepithelial
polyp
Papilloma
Naevus
Pyogenic
granuloma
Ameloblastoma
Pleomorphic
adenoma
Bony
exostosis
Most of these have the word
'oma'
at the end. So
'Oma'
usually indicates benign neoplasia
Haemangioma is abenign vasoformative neoplasm.What does this mean?
-It's formed from either capillaries or blood vessels.
-So can either be described as a
capillary
or
cavernous haemangioma
What is characteristic of a haemangioma?
Blanches
on
pressure
What can a haemangioma cause?
Troublesome bleeding or oral cosmetic defects e.g on the lip
How do you treat a haemangioma?
Cryotherapy/sclerotherapy (inject irritant into vascular space causing scaring) /excision
What is a lipoma and where can it occur?
-It's a benign neoplasm of adipose tissue
-can occur anywhere where there is subcutaneous/dermal fat (fatty tissue eg neck, oral cavity ,face.
What does a lipoma look like and how is it treated?
Soft yellow
or
pink
with
overlying mucosa
/
skin
Treat with
surgical excision
What is a fibroepithelial polyp (FEP)?
It's the most common benign epithelial tumour of the oral cavity (although uncommon before the age of 30)
& it's a painless flat or pedunculate lesion
How can a FEP be caused and how do you treat it?
Inflammatory hyperplasia due to chronic irritation e.g. cheek biting
Treat by local surgical excision if troublesome
What is a papilloma?
-Benign proliferating lesion caused by human papilloma virus (HPV-not oral cancer)
-is most common between age 30 - 50
What is a papilloma caused by?
HPV strains 6 & 11, not the cancer inducing type 16 & 18
Where are papillomas most common and how do you treat them?
-Soft palate and tongue
-Local surgical excision or cryotherapy if troublesome
What is a melanocytic naevi and how do you treat it?
-Pigmented
mole that develops in
childhood
&
early adult life
(
30-40
)
-Runs
in
families
(sun exposure/sun burn)
-Remove
by
local surgical excision
if troublesome or of concern
What is a pyogenic granuloma?
-It's a reactive hyperplasia of connective tissue (no pus ¬a granuloma)
-Usually due to low grade irritation, trauma, poor oral hygiene, hormonal change (so it's more common in females than in males)
Where are pyogenic granulomas most commonly found?
Gingiva, buccal mucosa, tongue & lips
How do you treat pyogenic granulomas?
Local
surgical
excision
(including
base
) plus improved
Oral hygiene
What is an ameloblastoma?
Benign tumour of odontogenic epithelium - usually found in x-rays
80% of these occur in the mandible, most commonly in the posterior region
What can ameloblastomas cause?
Expansion of the bone & resorption of adjacent tooth roots
Are ameloblastomas invasive?
Yes, they are actually locally invasive (very rarely metastatic spread to lung)
How do you treat ameloblastomas?
Surgical excision with margin/enucleation possible
Must be monitored - could re-occur
What are pleomorphic adenomas and what/who does it affect?
Most common salivary gland tumour (accounting for 80% of them)
Parotid gland more commonly affected
F>M 2:1
it can occur at any age but it's most frequent in 30-60 year olds
How are pleomorphic adenomas treated?
Careful surgical excision required
Can get bigger overtime and risk of malignancy.
What is a bony exostosis/ torus and where is it most common?
Benign localised peripheral overgrowth of bone.
Most common in palate and lingual aspect of mandible.
Why are bony exostoses frequently traumatised?
Due to location & thin mucosa
How do you treat a bony exostosis/torus?
Surgical reduction if functionally/cosmetically problematic
Summarise the content in this lecture.
-many do not need treatment