benign tumors 2010

8/8/2019 Benign Tumors 2010

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11/29/20

Benign Tumors

Characteristic features of benign

tumors

• Slow growing

• Well differentiated

• Remain localized

Histology

•Infrequent mitoses

•Little cytological variation

Tumor - an abnormal mass of

tissue whose growth exceeds and

is uncoordinated with that of

surrounding tissues.

Abnormal growth continues after the

stimulation which initiated it has

ceased

Characteristic features of

malignant tumors

• Fast growing

• Poorly differentiated

• Spread

• Metastasize (distant metastases via blood,

lymphatic or body cavities)

•High mitotic rate•Nuclear and cellular pleomorphism

•Abnormal mitoses

Characteristic features of locally

invasive tumors

• Slow or faster grow (benign type)

• invasion into surrounding tissues.

Example:

ameloblastoma

basal cell carcinoma („rodent ulcer”)

Benign tumors

• Fibroma

• Pyogenic granuloma

• Papiloma

• Peripherial giant cell granuloma

• Epulis

• Lipoma

• Odontoma

• Cementoma



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Fibroma• A benign tumor

consisting of fibrous

connective tissues

• Asymptomatic, pale, firm,

slow growing in form of

dense sparsely cellular

fibrous connective tissue

resulting from low

intensity, prolonged

chronic irritation.

Fibroma

• Typical localization:

– tongue, – lip,

– cheek,

tumor “mirors” places in

oral cavity where

excessive trauma

during biting can be

observed

• Treatment:

– removal of the irritant

– surgical removal of the

lesion – exsional biopsy

Fibroma Treatment

• Lenticular incision

Fibroma excision by means of

laserPyogenic granuloma

• An exuberant

proliferation of granulation tissue as an

exaggerated response to

irritation.

• Asymptomatic Red,

delicate tissue lesion

with tendency to

bleeding when

traumatized

Typical localization: interdental papillae, lip, cheek



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Pyogenic granuloma

• No pus !

• Not a granulomatictissue (histopathology-

reactive inflammatory

process)

• When multiple

traumatization

occurred vascular,

focally ulcerated parts

can be seen

Pyogenic granuloma

• Treatment

– removal of the irritant

– Surgical removal of the

lesion

– Gingival lesions:

• Excision + scaling of

adjacent teeth

TreatmentSquamous papilloma

• Squamous papilloma is a

benign tumor of squamous

epithelium.

• In response to irritation.

• Pedunculated papillary

growth from the mucosal

surface

• Cauliflower-like surface

Papilloma

• Broad base and afairly smooth surface

forms of tumor can be

observed in rare cases

• Remain benign.

• In some cases

papilloma virus has

been demonstrated in

region of tumor

Papilloma



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Inflammatory Papillary

Hyperplasia• Bubble-like configuration of

the mucosa over the hardpalate.

• Tissues are erythematous,edematous, with some densefibrous connective tissue

• Condition associated with apoorly fitting denture - pooradaptation to the mucosaallowing tissue to fill thespace possibly as a result of asuction effect.

Giant cell granuloma• Lesions is composed of giant

cells, fibroblasts andendothelial cells

• Two forms cental and

periphelial• Pale or red , asymptomatic

localized in atatched gingivaregion

• Sometimes rapid expantionwith swelling and pain

• May loose and/or displaceteeth.

Peripherial giant cell granuloma

• Clinically, may

resemble pyogenic

granuloma or they

may be quite vascular

and closely resemble

pyogenic granuloma.

• Hemorrhagic

appearance

• Superficial erosion to

bone

Peripherial giant cell granuloma

Lipoma

• Soft broad based swelling

occurring in the buccal

mucosa.

• yellowish appearance or

similar to the normal

mucosa

• Soft , fluctuant to palpation

• Slow-growing

Lipoma

• Treatment

– Surgical removal



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Lipoma -treatmentEpulis fissuratum

• Hyperplastic mass of

mucosa, proliferating

as a response to long-

term mechanicalirritation from an ill-

fitting denture

• Dense collagenous

connective tissue

Epulis fissuratum

• Typical localization:

vestibule

• Asymptomatic

• ulceration may be seen

when irritated locally

• must be removed prior

to making prosthesis

Pregnancy tumor• Local proliferation of very

vascular granulation tissue

• observed in 15% of pregnant women togetherwith diffuse gingival enlargement (proliferation of granulation tissue).

• Treatment postponed untilthe end of pregnancy;

• when traumatized or withtendency to excessive bleed,must be removed

Hemangioma

• Local vascularization

occur in young people,

often congenital.

• Asymptomatic, dark

discoloration, in response

to mechanical irritation

• Lesion blanches upon

pressure.

Hemangioma

• Unencapsulated and generally

extend into the surrounding

tissues.

• When traumatized significant

hemorrhage may occur

• tretment: chemical or surgical

remove



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Odontoma

• Complex odontoma is

disorganized mass of calcified material appearing

radiopaque on x-ray. These

are usually asymptomatic

lesions or may feature

slight expansion of the

cortical plates.

Odontoma

• Compond odontoma

small anomalous teethcan be seen sometimes

together with

unerupted tooth

Cementoma or Osteous Dysplasia

• Self-limiting fibro-osseous

process - abnormal bone

reaction to irritation or

stimulation.

• Typically multiple

radiolucencies at the apices

without oral manifestations

• The lesions may show

progressive calcification or

the same over many years.

Mixed tumor

• Asymptomatic of slowl growh,

rarely cause ulceration of the

overlying mucosa.

• Although they may appear to be

encapsulated clinically, the capsule

is usually found to be incomplete,

and any attempt at enucleation may

result in recurrence.

• Surgical excision with a border of

normal surrounding tissue.

benign tumors 2010

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