BENIGN AND MALIGNANT CONNECTIVE TISSUE TUMOURS FIBROMA MOST

BENIGN AND MALIGNANT CONNECTIVE TISSUE TUMOURS

FIBROMA MOST COMMON BENIGN SOFT TISSUE NEOPLASM REACTIVE FIBROUS HYPERPLASIA TO TRAUMA OR IRRITATION

C/F ANY ORAL SITE ALONG PLANE OF OCCLUSION COMMON SITE: GINGIVA, B. M, TONGUE, LIPS, PALATE ELEVATED NODULE NORMAL COLOUR SMOOTH SURFACE SESSILE OR PEDUNCULATED SMALL IN SIZE MOSTLY WELL DEFINED

C/F TRAUMATIC SURFACE ULCERATION HYPERKERATOSIS F: M = 2: 1 OCCURS AT ANY AGE Differential diagnosis: GIANT CELL FIBROMA NEUROFIBROMA GIANT CELL GRANULOMA MUCOCELE

Fibroma. .

Histopathologhic/Features BUNDLES OF INTERLACING COLLAGEN FIBRES FEW FIBROBLASTS, FIBROCYTES OR SMALL BLOOD VESSLES SURFACE EPITHELIUM – STRATIFIED SQUAMOUS TRAUMA – VASODILATION, EDEMA INFLAMMATORY CELL INFILTRATION SEEN PARTICULARLY LYMPHOCYTES

Fibroma. .

TREATMENT & PROGNOSIS SURGICAL EXCISION

GIANT CELL FIBROMA ORAL NEOPLASM FIRST DESCRIBED BY WEATHERS & CALLIHAN IN 1974

C/F ASYMPTOMATIC SMALL AND RAISED SESSILE OR PEDUNCULATED 10 – 30 YRS MANDIBULAR GINGIVA MOST COMMON FOLLOWED BY TONGUE, PALATE, BUCCAL MUCOSA AND LIPS

Giant cell fibroma. .

H/P UNENCAPSULATED MASS OF LOOSE FIBROUS C/T LARGE PLUMP, SPINDLE SHAPED & STELLATE FIBROBLASTS SOME MULTINUCLEATED CELLS PERIPHERALLY SUCH CELLS SURFACE EPITHELIUM – CORRUGATED & ATROPHIC

Giant cell fibroma. .

TREATMENT & PROGNOSIS EXCISION BIOPSY IS CURATIVE RECURRENCE RARE

PERIPHERAL OSSIFYING FIBROMA ANY AGE { COMMON IN CHILDREN & YOUNG ADULTS} F : M – 2: 1 WELL DEMARCATED FOCAL MASS OF TISSUE ON GINGIVA SESSILE OR PEDUNCULATED COLOUR NORMAL OR REDDENED SURFACE INTACT OR ULCERATED APPEARS TO ORIGINATE FROM INTERDENTAL PAPILLA MOST COMMON ANTERIOR TO MOLAR AREA

Peripheral ossifying fibroma. .

R/F SUPERFICIAL EROSION OF BONE ( FEW CASES)

Peripheral ossifying fibroma. .

H/P STRATIFIED SQUAMOUS EPITHELIUM INTACT OR ULCEARTED EXTREMELY CELLULAR WITH PROLIFERATING FIBROBLASTS DELICATE FIBRILLAR STROMA AREAS OF CALCIFICATION { MATURE LAMELLAR BONE OR IMMATURE CELLULAR BONE} SINGLE OR MULTIPLE INTERCONNECTING TRABACULAE OF BONE GLOBULES OF CALCIFICATIONS – ACELLULAR CEMENTUM DYSTROPHIC CEMENTUM

Peripheral ossifying fibroma. .

TREATMENT & PROGNOSIS SURGICAL EXCISION

CENTRAL OSSIFYING FIBROMA CENTRAL NEOPLASM OF BONE CONTROVERSY – CENTRAL CEMENTIFYING FIBROMA (OT) AND OTHER FIBRO OSSEOUS LESION

C/F AGE: 33 YRS SITE: MANDIBLE MORE AFFECTED ASYMPTOMATIC NOTICEABLE SWELLING MILD DEFORMITY DISPLACEMENT OF TEETH SLOW GROWING OVERLYING MUCOSA INTACT

Central ossifying fibroma. .

R/F APPEARANCE DEPENDS UPON STAGE OF DEVELOPEMENT INITIAL RADIOLUCENCY MATURE LESION RADIOLUCENT WITH RADIO-OPAQUE FLECKS LATER RADIO-OPAQUE MASSES WELL DEFINED/CIRCUMSCRIBED AND DEMARCATED LESION FROM SURROUNDING DISPLACEMENT OF TEETH

Central ossifying fibroma. .

H/P DELICATE INTERLACING COLLAGEN FIBRES ACTIVE PROLIFERATING FIBROBLASTS CELLULAR PLEOMORHISM – MILD SMALL FOCI OF IRREGULAR BONY TRABECULAE MATURE LESION WITH CALCIFICATION COALESCE

Central ossifying fibroma. .

TREATMENT & PROGNOSIS CONSERVATIVE EXCISION

MYOFIBROMA & MYOFIBROMATOSIS PREDOMINANT MYOFIBROBLASTS C/F – BENIGN & LESS AGGRESSIVE 26. 6 YRS H&N REGION I. O – TONGUE, LIPS & B. M JAW LESIONS – MAND LESIONS UNILOC & MULTI LOC FIRM SUBMUCOSAL NODULES OR EXOPHYTIC

H/P BIPHASIC PATTERN FASCICLES OF SPINDLE CELLS – EOSINOPHILIC CYTOPLASM – SMOOTH MUSCLE PRIMITIVE SPINDLE CELLS

Myofibroma. .

TREATMENT & PROGNOSIS CONSERVATIVE EXCISION

PERIPHERAL GIANT CELL GRANULOMA REACTIVE LESION LOCAL IRRITATION RECENTLY ROLE OF TRAUMA

C/F DENTULOUS & EDENTULOUS 4 TH – 6 TH DECADE FEMALE ASYMPTOMATIC SIZE IS AROUND 1 CM IN DIAMETER ORIGIN FROM PDL OR MUCOPERIOSTEUM COLOR VARIES SITE : MANDIBULAR GINGIVA , ALVEOLAR MUCOSA

Peripheral giant cell granuloma. .

H/P NON ENCAPSULATED DELICATE RETICULAR & FIBRILLAR C/T OVOID OR SPINDLE SHAPED C/T CELLS MULTINUCLEATED GIANT CELLS FOCI OF HEMORRHAGE HEMOSIDERIN PIGMENTS SPICULES OF OSTEOID OR BONE INFLAMMATORY CELL INFILTRATION STRATIFIED SQUAMOUS EPITHELIUM

Peripheral giant cell granuloma. .

GIANT CELLS ? OSTEOCLASTS GIANT CELLS ASSOCIATED WITH RESORPTION OF DEC TEETH ENDOTHELIAL CELLS

R/F PERIPHERAL CUFFING OF BONE SUPERFICIAL EROSION OF THE BONE

TREATMENT & PROGNOSIS CONSERVATIVE SURGICAL EXCISION

CENTRAL GIANT CELL GRANULOMA UNCOMMON BENIGN PROLIFERATION JAFFE CENTRAL GIANT CELL REPARATIVE GRANULOMA FEMALE PREDILICTION ANTERIOR SEGMENT [ MAY CROSS MIDLINE] SYMPTOMLESS EXP OF CORTEX PERFORATION MOBILITY, DISPLACEMENT OF TEETH ROOT RESORPTION

Central giant cell granuloma. .

TYPES NON AGGRESSIVE NO RESORPTION NO PERFORATION SHOWS NEW BONE FORMATION AGGRESSIVE RAPID GROWTH PAIN CORTICAL PERFORATION RESORPTION

R/F R/L AREA SMOOTH OR RAGGED BORDER DEFINITE LOCULATIONS CORTICAL PLATES – THIN & EXPANDED DISPLACEMENT OF TEETH

H/P LOOSE FIBRILLAR C/T STROMA PROLIFERATING FIBROBLASTS SMALL CAPILLARIES MULTINUCLEATED GIANT CELLS- - FIBROBLA - MONO/MACRO FOCI OF OLD EXTRAVASATED BLOOD HEMOSIDERIN PIGMENTS NEW BONE TRABACULAE AND OSTEOID

Central giant cell granuloma. .

TREATMENT & PROGNOSIS CURETTAGE SURGICAL EXCISION

GIANT CELL TUMOUR OF BONE NEOPLASM OF UNDIFFERENTIATED CELLS

C/F > 19 YRS FEMALES PAIN SWELLING OF AFFECTED REGION WEAKNESS LIMITATION OF MOTION OF JOINTS

H/P ROUND TO OVAL OR SPINDLE SHAPED CELLS NUCLEUS SURROUNDED BY ILL DEFINED CYTOPLASMIC ZONE DISCERNIBLE INTERCELLULAR SUBSTANCE MITOTIC FIGURES GIANT CELL – 40 – 60 NUCLEI SCATTERED UNIFORMLY

INFARCT LIKE NECROSIS COLLECTION OF FOAM CELLS

TREATMANT & PROGNOSIS CURETTAGE SEC MALIGNANT CHANGE

Giant cell tumor. .

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