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Benign Non-Odontogenic Tumors of Oral Cavity
Benign Non-Odontogenic Tumors of Oral Cavity
NON-ODONTOGENIC
TUMORS OF ORAL CAVITY
Banun Kusumawardani
Faculty of Dentistry
University of Jember
Definitions
Neoplasia
Neo: new; Plasia: formation.
A neoplasm is defined as an uncoordinated
proliferation of tissue, the growth of which
persists in a potentially unlimited fashion, even
after cessation of the stimulus which evoked the
change.
Difference between Hyperplasia and Tumor
Tumor is an abnormal mass of tissue, the growth
of which exceeds and is uncoordinated with that
of normal tissues and persists in the same
excessive manner after cessation of stimuli
which evoked the change.
Hamartoma : An abnormal
proliferation of tissues, native to that
part. It is a focal malformation which
resembles a neoplasm, grossly &
microscopically.
Teratoma: A neoplasm composed of
tissues not normally found in the organ, in
which it arises. Derivatives of all three
germ layers are seen.
Choriostoma: A mass formed by
maldevelopment of tissue, a type not
native to that site.
Heteroplasia: Development of
cytologic and histologic elements
not native to the part.
Malignant neoplasm -
endanger the life of the
patient.
Classification of tumors
cont
Benign tumor of the oral
cavity
Epithelial
Mesenchymal
Connective tissue
Blood vessels, nerves,
lymphoid glands
Bones
Classification of tumors
cont
Malignant tumors
Epithelial
Mesenchymal
Classification of tumors
cont
Benign tumor
Dental tissue (Odontogenic
tumors)
Non dental tissues
(Non Odontogenic tumors)
Malignant tumors
Properties of benign
tumors
Benign tumors- are tumors that are
Encapsulated berkapsul
Slow growth selowww
Grow by expansion, physically
pushing the normal adjacent
structures & tissues out of their path
Do not invade adjacent tissues
tak nyerang jaringan terdekat
Resemble their normal counterparts
(not anaplastic)
Do not metastasize g metastasis
Properties of malignant
tumors
Malignant tumors are tumors that
Not capsulated
Fast growth
Grow by infiltration into surrounding
tissues
Lost or do not resemble tissue of origin
(anaplastic)
Capable of metastasis into distant
regions/tissues through Lymph or
blood circulation
Endanger patients life
Benign tumors-
Nomenclature
Cells of benign tumors
resemble tissue of origin.
No histological difference are
visible between tumorous and
normal cells.
Are named after the tissue of
origin with ending (suffix)
oma.
Benign tumors cont
Examples
Fibroma- fibrous tissue
Lipoma- adipose tisssue
Malignant tumors-
Nomenclature
Tumor cells differ clearly from the
normally differentiated cells.
Sometimes difference is great that
it is difficult to discover the tissue
of origin (poorly differentiated or
highly anaplastic).
Nomenclature is based on tissue of
origin
Carcinoma epithelial cancer
Adeno carcinoma- glandular cancer
Malignant tumors cont
Sarcoma malignant tumor of
mesenchymal tissue.
For mesenchymal tissue start with
the name of tissue then followed by
sarcoma
Example
Fibrosarcoma Fibrous tissue
Rhabdomyosarcoma from skeletal
muscles.
Leiomyosarcoma
Osteosarcoma
Signs and symptoms of
tumors
Nature of symptoms varies with the
according to the location of the
lesion
Oral lesions in asymptomatic phase
may first be recognized by the
patient
Irregularity or abnormality of the
contour may be discovered while
brushing the teeth
Bleeding may draw attention
Signs and symptoms of
tumors
Loosening of one or more teeth may
occur if the alveolar ridge is
involved
Tongue movement may be
influenced and protrusion limited
because of infiltration & fixation of
the lesion to the floor of the mouth
Persistent sore throat for lesions of
the palate, tonsilar fossa, or base of
tongue
Signs and symptoms of
tumors
Pain may be intermittent initially
but becomes progressively more
intense and prolonged
Local pain eventually develops as
the tumor invades adjacent
structures
Pain frequently referred to the
ear
Clinical features of oral
tumors
Sign Benign Malignant
Can be
True neoplasms
Odontogenic tumors
Non odontogenic tumors
Developmental anomalies or
overgrowth
Other lesions related to bone
Effects on adjacent
structures
Non-Odontogenic benign
tumors
Non-odontogenic tumors
Tumors not arising from the tooth or tooth-
like structures
can be tumors of:
Epithelial origin (Mostly are premalignant:
see under malignant tumors)
Connective tissue origin
Vascular origin
Nerve origin
Muscle origin
Bone origin
Tumor-like of bone origin
Connective tissue origin
Radiographic Features
Well-defined unilocular radiolucency
Large lesions: classic downward bowing of the inferior
cortex of mandible
Ossifying Fibroma
Ossifying Fibroma
Histopathology
Tissue submitted as one mass
Fibrous connective tissue with varying degree of
mineralized material
Treatment
Enucleation; good prognosis
Osteoma
Itoccurs as a peripheral or as a central
tumor (very seldom).
Clinically present;
Hard, smooth, very slowl growing,
circumscript (round) tumor of the jaw bones.
Observed in individuals over 40 years old.
The mandible more often involved than
maxilla.
The growth sometimes selflimited.
On x-ray appears as radiopaque mass with
radioluscent outline.
Treatment is excision of the tumor.
Osteoma and Gardner Syndrome
Gardner Syndrome
Autosomal dominant
Spectrum of diseases comprised of
* familial colorectal polyps (will transform to adenocarcinomas)
* Osteomas (90% of cases) common in the skull, paranasal
sinuses and mandible
* Epidermoid cysts
* Desmoid tumors (locally aggressive fibrous neoplasms)
* Increased incidence of thyroid carcinoma
Cementoblastoma (True Cementoma)
Odontogenic neoplasm of cementoblasts
Mandible > Maxilla with 90% occur in molar/premolar area
50% INVOLVE THE 1ST PERMANENT MOLAR
Children and young adults
Pain at night relieved by aspirin
Swelling
Radiographic Features
Appears as radiopaque mass fused to one or more roots and
is surrounded by a thin radiolucent rim
Outline of root blurred due to fusion with tooth
Histopathology
Sheets of thick trabeculae of mineralized material intermixed
with cellular fibrovascular tissue with multinucleated giant cells
Treatment
Surgical extraction of lesion with teeth
Classification of Non Odontogenic Tumours
Epithelial
Benign Malignant
Papilloma Basal Cell Carcinoma
Squamous Acanthoma Epidermoid carcinoma or
Keratoacanthoma Squamous cell carcinoma
Pigmented Cell Nevus Verrucous Carcinoma
Spindle Cell Carcinoma
Premalignant
Adenoid Squamous cell
Leukoplakia
Carcinoma
Leukoedema Lmphoepithelioma and
Intraepithelial Carcinoma Transitional cell
or Carcinoma in situ carcinoma
Erythroplakia Malignant Melanoma
Oral Sub Mucous Fibrosis
Classification of Non Odontogenic Tumours..
Connective Tissue Adipose tissue
Benign Benign
Fibroma Lipoma
Giant Cell Fibroma Verruciform
Peripheral Ossifying Xanthoma
Fibroma Malignant
Central Ossifying Fibroma Liposarcoma
Peripheral Giant cell
Granuloma
Central GCG
Aneursmal Bone Cyst
Myxoma
Malignant
Fibrosarcoma
Classification of Non Odontogenic Tumours