F3 NEURAL, FAT & MUSCLE LESIONS PT1

• Trauma from surgical procedures

  TRAUMATIC NEUROMA
• Radiating facial pain


  TRAUMATIC NEUROMA
• Most common location TRAUMATIC NEUROMA

  mental foramen
• GRANULAR CELL TUMORS Former name:

  granular cell myoblastoma
• GRANULAR CELL TUMORS origin

  Schwann cell
• GRANULAR CELL TUMORS Related lesion

  congenital gingival granular cell tumor (congenital epulis)
• Common location in H&N GRANULAR CELL TUMORS

  tongue
• GRANULAR CELL TUMORS 50% of cases

  Pseudoepitheliomatous hyperplasia of oral epithelium
• overdiagnosis of SCCA


  Overlooked granular cells
• CONGENITAL EPULIS OF THE NEWBORN other name

  Congenital Gingival Granular Cell Tumors
• MX Anterior gingiva of newborns

  CONGENITAL EPULIS OF THE NEWBORN
• SCHWANNOMA Other name


  Neurilemmoma
• Favored location SCHWANNOMA


  tongue
• sometimes thought due to intralesional hemorrhage)


  SCHWANNOMA
• palisaded whorls and waves, surround acellular eosinophilic zone (verocay body) representing reduplicated BM and cytoplasmic cellular processes

  Antoni A areas
• spindle cells haphazardly distributed in a delicate fibrillar microcystic matrix, by immunochemistry tumor strongly expresses S-100 protein, (-) stains for actin and desmin

  Antoni B tissue
• (microscopic variant) has been described to designate degenerative changes in long-standing schwannoma

  Ancient schwannoma
• Neurofibromatosis syndrome 


  von Recklinghausen’s disease of skin
• NEUROFIBROMA 2 subsets: 


  NF1 and NF2 gene
• Most common site


  tongue, buccal mucosa and vestibule
• Oral lesions are associated with 


  NF1
• enlarged fungiform papillae and bone abnormalities; oral manifestations seen in 70% of NF cases


  Oral stigmata
• >= 6 café-au-lait macules at any location >1.5cm in diameter = suggestive of neurofibromatosis
• axillary freckling 


  Crowe’s sign
• iris freckling


  Lisch spots
• Most common site in Md NEUROFIBROMA

  mandibular nerve
• MD involvement: accompanying radiographic sign may be the formation of a flaring of inferior alveolar foramen, the so-called


  blunderbuss foramen
• Comprise a group of conditions characterized by neoplasms arising in several endocrine organs

  MUCOSAL NEUROMA OF MULTIPLE ENDORCINE NEOPLASIA SYNDROME TYPE III
• MEN type III


  MEN 2b
• has oral manifestations (autosomal dominant trait)

  MEN type III aka MEN 2b
• MEN III is caused


  RET oncogene
• RET Gene is responsible for


  MEN II (MEN 2a)
• Oral lesions men


  tongue, lips and buccal mucosa
• benign neoplasm that produces catecholamines that may cause significant

  Pheochromocytoma