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level: MALIGNANT NON ODONTOGENIC NEOPLASM OF THE JAWS

Questions and Answers List

level questions: MALIGNANT NON ODONTOGENIC NEOPLASM OF THE JAWS

QuestionAnswer
Second most common primary bone tumorOSTEOSARCOMA
OSTEOSARCOMA (site of origin): arise within medullary cavityConventional
OSTEOSARCOMA (site of origin):arise from periosteal surfaceJuxtacortical
OSTEOSARCOMA (site of origin):arise in soft tissueExtraskeletal
membrane that covers the outer surfaces of bone, outermost surface of boneperiosteal surface
hollow part of the bone that contains the bone marrowmedullary cavity
mandibular paresthesia can occur in osteosarcoma if ________ is involvedinferior alveolar nerve
OSTEOSARCOMA: clinical features:swelling, localized pain, loosening & displacement of teeth
maxillary paresthesia can occur in osteosarcoma if ________ is involvedinfraorbital nerve, epistaxis, nasal obstruction, or eye problem
OSTEOSARCOMA(RADIOGRAPHIC): the more ___________- the more presence of radiopaque discolorationcalcification
OSTEOSARCOMA(HISTOPATHOLOGIC): Sarcomatous stroma directly producing _________tumor osteoid
OSTEOSARCOMA(HISTOPATHOLOGIC patterns): malignant bone and ostoid bone predominateOsteoblastic
OSTEOSARCOMA(HISTOPATHOLOGIC patterns): most common; the jawsChondroblastic
OSTEOSARCOMA(HISTOPATHOLOGIC patterns): spindle cells predominateFibroblastic
OSTEOSARCOMA(HISTOPATHOLOGIC patterns): multiple aneurysmal blood-filled spaces lined by malignant cellsTelangiectatic
OSTEOSARCOMA(HISTOPATHOLOGIC): More ___________ in jaw than those in the skeleton, better prognosisdifferentiated
OSTEOSARCOMA(DX): widening of periodontal ligament spaceScleroderma
OSTEOSARCOMA(DX): moth eaten radiographic appearanceChronic osteomyelitis, other malignancies, several benign neoplasms
OSTEOSARCOMA(DX): sclerotic radiographic appearancePindborg tumor and metastatic carcinomas
OSTEOSARCOMA(DX): histologic appearanceChondrosarcoma, fibrosarcoma of bone, aneurysmal bone cyst or giant cell tumor
(removal of the portion of mandible or maxillary)Radical mandibulectomy or maxillectomy
OSTEOSARCOMA(TX): for recurrences, soft tissue extension metastatic diseaseRadiotherapy and chemotherapy
OSTEOSARCOMA(TX): mandibular osteosarcomaPresurgical insertion of radium needles
OSTEOSARCOMA(TX): survival rate of ___ in 5 years for tx using Presurgical insertion of radium needles76%
OSTEOSARCOMA (PROGNOSIS):Overall, 5 year survival rate for ___________of jaw osteosarcoma35 to 40%
OSTEOSARCOMA (PROGNOSIS): what arch has a better prognosismandibular
OSTEOSARCOMA (PROGNOSIS):Rarely metastasize tolymph nodes
OSTEOSARCOMA (PROGNOSIS):Most common sites of metastasis – ______; ______ survival ratelung and brain; 6 months
OSTEOSARCOMA (PROGNOSIS):Local recurrences –surgical excision and chemotherapy
JUXTACORTICAL OSTEOSARCOMA: Usually of _____ typeparosteal
JUXTACORTICAL OSTEOSARCOMA: Most common type osteosarcomaPAROSTEAL
JUXTACORTICAL OSTEOSARCOMA: Not covered by the lining epithelial tissuePAROSTEAL
JUXTACORTICAL OSTEOSARCOMA: Rare; Distinct cx,hx, biologic and rx featuresPERIOSTEAL
JUXTACORTICAL OSTEOSARCOMA: Arise the periphery of bone at the _____ surfacePERIOSTEAL
PAROSTEAL OSTEOSARCOMA is common inlong bones
PAROSTEAL OSTEOSARCOMA: genderfemale
PAROSTEAL OSTEOSARCOMA:Most commonly involvesdistal femoral metaphysic
PAROSTEAL OSTEOSARCOMA:CLINICAL FEATURESSlow-growing swelling or palpable mass, dull aching sensation
JUXTACORTICAL OSTEOSARCOMA: Periphery is ossified than the base, may have lobulated cartilaginous cap or may be irregular because extensions into soft tissuePAROSTEAL OSTEOSARCOMA
PAROSTEAL OSTEOSARCOMA(radiographic):Radiodense and attached to the external surface of the bone by broad ___________sessile base
PAROSTEAL OSTEOSARCOMA: salient featureWell-differentiated has spindle shape stroma with minimal atypia and rare mitotic figures
JUXRACORTICAL OSTEOSARCOMA: Well-differentiated has spindle shape stroma with minimal atypia and rare mitotic figures separating irregular trabeculae of woven bone having foci of osteoid and cartilagePAROSTEAL OSTEOSARCOMA
PAROSTEAL OSTEOSARCOMA (TX)En bloc resection
PAROSTEAL OSTEOSARCOMA: PROGNOSISSignificant local recurrence underlying cortical bone
PERIOSTEAL OSTEOSARCOMA: Common locationupper tibial metaphysis
PERIOSTEAL OSTEOSARCOMA: CLINICAL FEATURESrarely in jaw, occurs less
JUXTACORTICAL OSTEOSARCOMA(radiographic): Cortex of involved bone radiographically intact and sometimes thickened, with no tumor involvement of the underlying marrow cavityPERIOSTEAL OSTEOSARCOMA
JUXTACORTICAL OSTEOSARCOMA(histo): Lobules of poorly differentiated malignant cartilage with central ossification, minimal tumor infiltration into cortical bone without medullary involvementPERIOSTEAL OSTEOSARCOMA
PERIOSTEAL OSTEOSARCOMA (DX)Chondroblastic intramedullary osteosarcoma
CHONDROSARCOMA(CLINICAL):Maxillofacial area (60%) –lateral incisor and canine region and palate
CHONDROSARCOMA: SYMPTOMSPain, visual disturbances, nasal signs and headaches
CHONDROSARCOMA(CLINICAL):Mandibular area (40%) –premolar, molar, symphysis, coronoid and condylar process
CHONDROSARCOMA: occur more onanterior area
CHONDROSARCOMA: ageAdulthood and old age
CHONDROSARCOMA(Radiographic):Moth – eaten radiolucency; diffuse opaque; uni/multi, mottle densities
CHONDROSARCOMA(HISTOPATHOLOGIC FEATURES GRADING):well differentiated; lobular architectureGrade I
CHONDROSARCOMA(HISTOPATHOLOGIC FEATURES GRADING):intermediate; myxoid stroma w/ enlarged chondrocyte nucleiGrade II
CHONDROSARCOMA(HISTOPATHOLOGIC FEATURES GRADING):poorly differentiated; celular; spindle cell componentGrade III
CHONDROSARCOMA: TXWide local radical surgical excision
CHONDROSARCOMA: METASTASISlungs or bone
CHONDROSARCOMA:local recurrence and extension into adjacent vital structures result indeath
Highly lethal round cell sarcomaEWING’S SARCOMA
EWING’S SARCOMA:common locationBones of lower extremity of pelvis
EWING’S SARCOMA: common loc in jawRamus of mandible
EWING’S SARCOMA: symptomsPain and swelling, mucosal ulcers, Facial deformity, destruction of alveolar bone with loosening of teeth
EWING’S SARCOMA(HISTOPATHOLOGIC):Proliferation of _________- cells that may be compartmentalized by fibrous bandsuniform, closely packed
EWING’S SARCOMA(HISTOPATHOLOGIC):Round to oval nuclei have ________- inconspicuous nucleolifinely dispersed chromatin
EWING’S SARCOMA(HISTOPATHOLOGIC):Cytoplasm hasglycogen
EWING’S SARCOMA(HISTOPATHOLOGIC):stains withSchiff stain
EWING’S SARCOMA: problem with chromosomes translocation11 and 12
EWING’S SARCOMA: radiographicMoth eaten destructive radiolucency medullar and erosion of cortex with expansion
EWING’S SARCOMA: tx localsurgery and radiation
EWING’S SARCOMA:tx systemicchemotherapy
EWING’S SARCOMA:prognosis for patient below 30 years oldpoor
EWING’S SARCOMA:Metastatic tolungs, other bones and lymph nodes
EWING’S SARCOMA: high rate oferythrocyte sedimentation
EWING’S SARCOMA: elevated value ofserum lactate dehydrogenase & thrombocytosis
Burkitt's Lymphoma: Chromosome problem8-14
BURKITT’S LYMPHOMA(CLINICAL):High-grade non-hodgin’s lymphoma ______ in Africaendemic
BURKITT’S LYMPHOMA(CLINICAL):High-grade non-hodgin’s lymphoma _____ in North Americasporadical
BURKITT’S LYMPHOMA: HISTOPATHNeoplastic B cell proliferation
BURKITT’S LYMPHOMA: radiographMoth-eaten radiolucency
BURKITT’S LYMPHOMA: TXCombination chemotherapy
BURKITT’S LYMPHOMA: PROGNOSISPotentially curable
low red blood cell countAnemia
low white blood cell countLeukopenia
low platelet countThrombocytopenia
high calcium level in the bloodHypercalcemia
MULTIPLE MYELOMA: gendermale
MULTIPLE MYELOMA: ageafter 5th decade
MULTIPLE MYELOMA: may developsystemic amyloidosis
Asymptomatic or may have pain, swelling, expansion, numbness, mobility of the teeth, or pathologic features; soft tissue massMULTIPLE MYELOMA
Weakness, weight loss, anemia and hyper viscosityMULTIPLE MYELOMA
MULTIPLE MYELOMA: radiographicpunched out, expansile, osteosclerotic
MULTIPLE MYELOMA: histoMonotonous proliferation of pure plasma cells
MULTIPLE MYELOMA:TXChemotherapy with local radiation
MULTIPLE MYELOMA:Poor prognosis for patients withsevere azotemia, hypercalcemia, anemia
SOLITARY PLASMACYTOMA OF BONE: ageadulthood
SOLITARY PLASMACYTOMA OF BONE: gender predominancemale
SOLITARY PLASMACYTOMA OF BONE:rare injaw
SOLITARY PLASMACYTOMA OF BONE: occur more inangle of mandible
SOLITARY PLASMACYTOMA OF BONE:Diagnosisradiologic bone survey and random bone marrow aspirate and biopsy
SOLITARY PLASMACYTOMA OF BONE: symptomsPain, swelling, pathologic fracture
SOLITARY PLASMACYTOMA OF BONE: histopathmonotonous proliferation of neoplastic plasma cells
SOLITARY PLASMACYTOMA OF BONE: radiographicWell defined lytic lesions
May be multilocular, resembling central giant cell granuloma; May destroy cortical bone and spread into adjacent soft tissueSOLITARY PLASMACYTOMA OF BONE
SOLITARY PLASMACYTOMA OF BONE: txradiotherapy
SOLITARY PLASMACYTOMA OF BONE:Local recurrence in ___of cases10%
SOLITARY PLASMACYTOMA OF BONE:May progress tomultiple myeloma
Most common malignancy affecting skeletal bonesMETASTATIC CARCINOMA
From primary carcinomas of the breast, kidney, lung, colon, prostate, thyroid glandMETASTATIC CARCINOMA
METASTATIC CARCINOMA: age50-70 (ave-45)
METASTATIC CARCINOMA: locationangle and body of mandible
Bone pain, loosening of teeth, lip paresthesia, bone swelling, gingival mass, and pathologic fractureMETASTATIC CARCINOMA
METASTATIC CARCINOMA: radiographicPoorly marginated, radiolucent, irregular, moth-even, expansile defects
METASTATIC CARCINOMA: txSurgical excision, chemoradiotherapy
METASTATIC CARCINOMA: 5-year-survival10%
METASTATIC CARCINOMA: dead w/in a yeartwo-thirds