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OMPR Exam 4 Questions And Correct Answers
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OMPR Exam 4 Questions AndCorrect Answers
Odontogenic tumors (epithelial, mesenchymal, mixed epi/mesenchymal)
What are the epithelial tumors? - Answer Ameloblastoma (also peripheral variant)
Calcifying odontogenic cyst/ CCOT
Adenamatoid Odontogenic tumor
Calcifying epithelial odontogenic tumor
Odontogenic keratocyst/KCOT
Odontogenic tumors (epithelial, mesenchymal, mixed epi/mesenchymal)
What are the mesenchymal tumors? - Answer Myoxma
Cemento-ossifying fibroma (also peripheral variant)
Cementoblastoma
Odontogenic tumors (epithelial, mesenchymal, mixed epi/mesenchymal)
What are the mixed epithelial and mesenchymal tumors? - Answer Ameloblastic fibroma
Odontoma
Ameloblastoma
(epithelial odontogenic tumor)
Characteristics? - Answer - benign, slow growing tumor
- locally aggressive
- can cause extensive destruction
- *80% in the mandible, mostly in molar-ramus area*
- usual clinical presentation: asymptomatic swelling of the affected bone
- broad age range - most are diagnosed in adults
- recurrence is common
Where is the most common location of ameloblastoma? - Answer posterior mandible
(ramus area) 66%
,but can occur anywhere in the jaw bones
Histo of Ameloblastoma? - Answer - unencapsulated
- infiltrates into surrounding tissue
- *Common follicular type*: islands with ameloblast-like epithelial cells surrounding
areas resembling stellate reticulum
- Other variants: plexiform, granular cell, desmoplastic, acanthomatous
What is the most common type of Ameloblastoma by far? - Answer Follicular type
islands with ameloblast-like epithelial cells surrounding areas resembling stellate
reticulum
Key microscopic features: *islands, sub nuclear vacuolization, central stellate
reticulum*
How does ameloblastoma appear on radiograph? - Answer - usually well defined
radiolucency
- smaller tumors are unilocular
- larger tumors are multilocular
Tx for Ameloblastoma? - Answer - resection with 1cm margins is best tx
- approx 15% recurrence rate
- rare cases of ameloblastic carcinomas
What are general characteristics of Calcifying Odontogenic Cyst? - Answer Cyst vs
Tumor? WHO classified as tumor CCOT (calcifying cystic odontogenic tumor)
- intraosseous lesion - also peripheral
- usually *unilocular* but may be multilocular
- age range: children to adults
- maxilla = mandible; *anterior jaws favored*
- often associated with *calcifications or unerupted teeth, or odontomas*
What is the most common location of Calcifying Odontogenic Cyst? - Answer *anterior
maxilla!! then anterior mandible*
can occur anywhere
Histo of Calcifying Odontogenic Cyst? - Answer - often see cyst lumen, lining, and wall
,- KEY characteristic *dark pink "ghost" cells*
- calcifications
Radiographic appearance of Calcifying Odontogenic Cyst? - Answer - Well-defined
*mixed* radiolucent-radiopaque lesion
- *may be associated with impacted tooth or odontoma*
What is the tx of Calcifying Odontogenic Cyst? - Answer - simple surgical enucleation
- low recurrence
What is the Adenomatoid Odontogenic Tumor? - Answer (*2/3rds tumor: teenage girls,
anterior maxilla, impacted canine*)
- benign
- encapsulated
- 70% occur in young women <20 years old
- 70% involve the anterior part of the jaws
- Maxilla much more commonly affected than mandible
- often associated with impacted/unerupted teeth, usually canines
- usually asymptomatic
- does not recur
The vast majority of Adenomatoid Odontogenic Tumor cases occur: - Answer *anterior
maxilla and anterior mandible*
2:1 (max versus mandible)
Histo of Adenomatoid Odontogenic Tumor? - Answer - encapsulated
- duct-like structures (adenomatoid)
- whorls and large masses of epithelial cells
- scattered calcifications within the tumor
What benign tumor has snowflake like calcifications on radiograph? - Answer
Adenomatoid Odontogenic Tumor
(vs COT which is more/larger coarse calcifications)
Radiographic appearance of Adenomatoid Odontogenic Tumor? - Answer - well
circumscribed radiolucency
, - simulates a dentigerous cyst - but radiolucency extends beyond the CEJ
- often associated w/ impacted tooth
- radiopacities within the tumor
Tx for Adenomatoid Odontogenic Tumor? - Answer - simple enucleation
- almost no recurrence
What is Calcifying Epithelial Odontogenic Tumor (Pindborg Tumor)? - Answer - rare
tumor; 1% of all odontogenic tumors
- broad age range - most patients with Calcifying Epithelial Odontogenic Tumor are
adults
- Mandible 2x more than maxilla
- *premolar/molar area is the most common location*
- many are associated with impacted teeth
What is the most common location of Calcifying Epithelial Odontogenic Tumor? - Answer
Posterior mandible (premolar/molar area) 57%
posterior maxilla 21%
much less in anterior mand (14%) and max (8%)
What is the histologic appearance of Calcifying Epithelial Odontogenic Tumor? - Answer
- islands and sheets of *uniform epithelial cells* with round nuclei
- *KEY microscopic features: amyloid like deposits and calcifications in the tumor*
congo red stain helps to ID the amyloid deposits
Radiographic appearance of Calcifying Epithelial Odontogenic Tumor? - Answer -
unilocular or multilocular radiolucency
- calcifications within the tumor appear as radiopacities within the radiolucency
*calcifications right around the crown of impacted tooth*
Tx of Calcifying Epithelial Odontogenic Tumor? - Answer - Conservative local resection
- good prognosis - less aggressive than ameloblastoma
What are the 2 MOST COMMON odotogenic lesions?
Boards ?*** - Answer Ameloblastoma and Odontogenic Keratocyst
What syndrome is associated with Odontogenic Keratocyst? - Answer Nevoid Basal Cell
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