this ppt is covering the following topics osteoma chondroma myxoma

1. Submitted to:
DEPARTMENT OF ORAL PATHOLOGY
Osteoma,
Chondroma,
Myxoma

2.  The osteoma is a benign neoplasm characterized by a proliferation of
either compact or cancellous bone, usually in an endosteal or
periosteal location

3.  The osteoma is not a common oral lesion. Although it
may arise at any age, it seems to be somewhat more
common in the young adult
 The osteoma is a slow-growing tumor, and so the patient
does not usually become alarmed
 The osteoma of endosteal origin is slower to present
clinical manifestations, since considerable growth must
occur before there is expansion of the cortical plates
 Multiple osteomas of the jaws, as well as of long bones
and skull, are a characteristic manifestation of Gardner
syndrome

4.  The soft-tissue osteoma of the oral cavity is a relatively
uncommon lesion, a total of 25 cases from the
literature being reviewed and reported by Krolls and his
coworkers.
 These lesions occur almost exclusively in the tongue,
although occasional cases are found in the buccal
mucosa. They occur at any age and present as a firm
nodule
 The lesion may range up to 2cm as studied by Krolls
 Although soft tissue osteoma is rare but out of 25
cases studied 18 of them were female 7 of them were
male

5.  The central lesion usually appears
within the jaw as a well-circumscribed
radiopaque mass which is
indistinguishable from scar bone
 Sometimes this osteoma is diffuse
 But it must be differentiated from
chronic sclerosing osteomyelitis
 The periosteal form of the disease also
is manifested as a sclerotic mass

6. The osteoma is composed either of extremely
dense, compact bone or of coarse cancellous
bone
In any given area the bone formed appears
normal
The lesion is most often well circumscribed, but
not encapsulated
In some tumors foci of cartilage may be found,
in which case the term ‘osteochondroma’ is
often used

7. Treatment consists of surgical removal if
the lesion is causing difficulty or if a
prosthetic appliance is to be constructed
The osteoma does not recur after surgical
removal

8. • Osteoid osteoma
• Mostly occur in
the jaws
• Trauma or
inflammation
common
aetiology
• Benign
Osteoblastoma
• lacks the
characteristic pain
and the halo of
sclerotic bone
• More then 1.5cm

9.  The osteoid osteoma is a benign
tumor of bone which has
seldom been described in the
jaws
 Although true nature and
etiology is still unknown but
some researchers have claimed
that the lesion generally occurs
as the result of the trauma or
inflammation

10.  The osteoid osteoma usually occurs in young
persons, seldom developing after the age of 30
years
 Osteoid osteoma is more predominant in
males compared to female by the ratio 2:1
 One of the chief symptoms of the condition is
severe pain
 The pain of osteoid osteoma is described as
unrelenting and sharp, worse at night
 Localized swelling of the soft tissue over the
involved area of bone may occur and may be
tender

11. It is present both in maxilla as well as
mandible total 7 cases green had
studied 4 were of mandible 3 were of
maxilla
Out of maxilla lesion 3 were in the body
1 in condyle
while one maxillary lesion involved the
antrum

12. Radiographically, the osteoid osteoma presents a pathognomonic
picture characterized by a small ovoid or round radiolucent area
surrounded by a rim of sclerotic bone
The central radiolucency may exhibit some calcification
The lesion itself is larger then 1 cam in diameter

13. • The microscopic appearance of the osteoid osteoma
is characteristic and consists of a central nidus
composed of compact osteoid tissue
• varies in degree of calcification
• Formation of definite trabeculae occurs, particularly
in older lesions, outlined by active osteoblasts
• The overlying periosteum exhibits new bone
formation, and in this interstitial tissue collections of
lymphocytes may be noted

14.  Osteoid osteoma and benign osteoblastoma are significantly similar histologically but one
can tell them apart by radiodiagnosis
 it does not share the markedly limited growth potential of the average osteoid osteoma
 osteoblastoma frequently lacks the characteristic pain and the halo of sclerotic bone
associated with osteoid osteoma
 Osteoblastoma lesions are generally larger then 1.5 cm
 The term giant osteoid osteoma is generally is used when indication benign osteoblastoma

15. •This central bone tumor occurs most frequently in young
persons, approximately 75% of the patients being under 20
years of age and 90% under 30 years of age
•The lesion is characterized clinically by pain and swelling at
the tumor site, the duration being just a few weeks to a year
or more
•Unlike osteoid osteoma the pain isn’t relived drugs
The most common site of occurrence is the vertebral
column
The osteoid osteoma occur in maxilla and mandible with
the same frequency

16. • The lesion is not distinctive but, on
the radiograph, appears rather well
circumscribed
• radiolucent-radiopaque appearance
• In some instances, there is purely
bone destruction, while in other
cases there is sufficient bone
formation

17.  The vascularity of the lesion with many
dilated capillaries scattered throughout
the tissue
 The moderate numbers of
multinucleated giant cells scattered
throughout the tissue
 The actively proliferating osteoblasts
which pave the irregular trabeculae of
new bone
 These osteoblasts often appear so active
and are present in such numbers that, in
the past, mistaken diagnosis of
osteosarcoma have often been rendered

18. • The chondroma, a benign central tumor
composed of mature cartilage, is a well-
recognized entity in certain areas of the
bony skeleton
• It is uncommon in the maxilla and mandible
• The lesion is of considerable clinical
importance because of the propensity of
the tumor to undergo malignant
degeneration in some instances
• chondroma seldom develops in membrane
bones, particularly if no vestigial
cartilaginous rests are present

19. • This neoplasm may develop at any age and shows
no apparent gender predilection
• The chondroma usually arises as a painless,
• slowly progressive swelling of the jaw which, like
many other neoplasms, may cause loosening of
the teeth.
• The anterior portion of the maxilla is the most
frequent site of involvement by this tumor
because it is here that vestigial cartilage rests are
found, particularly in the midline lingual to or
between the central incisors
• Although some cases have been reported in soft
palate as well
• The mandible the most common site of
occurrence is posterior to the cuspid tooth,
involving the body of the mandible

20.  The radiograph shows an
irregular radiolucent or
mottled area in the bone
 The chondroma is a
destructive lesion and, in
addition, has been shown to
cause root resorption of
teeth adjacent to it.

21. • There is a narrow difference between
chondroma and chondrosarcoma
• The chondroma is made up of a mass of hyaline
cartilage which may exhibit areas of
calcification or of necrosis
• The cartilage cells appear small, contain only
single nuclei and do not exhibit great variation
in size, shape or staining reaction

22.  The treatment of the
chondroma is surgical, since
the tumor is resistant to X-ray
radiation
 The aggressive approach is
used because it could covert
to chondrosarcoma

23. • Myxoma is a heterogeneous group of soft tissue
tumors which have a common histologic
appearance of abundant myxoid ground substance
• It is composed of stellate cells arranged in loose
mucoid stroma
• The lesion is benign and does not metastasize,
although it frequently infiltrates adjacent tissues
• The myxoma of the soft tissues is a tumor which
has been described by Stout as a true neoplasm
made up of tissue resembling primitive
mesenchyme

24. • Superficial
angiomyxoma
• Poor to moderately
circumscribed, multil
obular
• Scattered thin-walled
vessels
• Intramuscular myxoma
• Poorly circumscribed
• Hypocellular variant;
hypercellular variant;
bland spindle cells
• Aggressive angiom
yxoma
• Infiltrative
• Uniformly
distributed
medium-sized
• Loose myxoid to
focally collagenous
• Neurothekeo
ma (Nerve
sheath
myxoma)
• Well
circumscribed
• spindled
cells in
fascicles and
whorls Nerve sheath myxoma
Im myxoma

25.  Most soft-tissue myxomas are deeply
situated lesions, occurring in the skin or the
subcutaneous tissues
 This tumor may make its appearance at any
age, approximately equal numbers of cases
having been reported in every decade of life
 There is no definite gender predilection of
this neoplasm

26. The intraoral soft-tissue myxoma
is an extremely rare lesion. The
majority of oral cases
undoubtedly represent only
myxomatous degeneration in a
fibrous tumor, and these cannot
be considered true myxomas,

27. • The nerve sheath myxoma is a benign tumor thought to
arise from perineural cells of peripheral nerves and is
characterized by the occurrence of stellate cells in a
prominent mucoid matrix
• A few cases have been reported in the oral cavity on the
tongue, buccal mucosa and retromolar area
• Their ultrastructural studies, along with those of Webb,
supported the perineural origin of these lesions. They are
treated by local excision and do not recur

28. • The lesion is composed of a loose textured
tissue containing delicate reticulin fibers and
mucoid material
• Within the loosely arranged tissue, stellate shaped
cells are sparsely distributed
• The tumor is not encapsulated and can invade
into the surrounding tissues

29.  The treatment of the myxoma
is essentially surgical, since X-ray radiation is of
little benefit.
 Although Recurrence is common, but this is not
of grave concern,
since the tumor does not metastasize
 The attempt to avoid
recurrence may necessitate the sacrifice of an
appreciable
amount of apparently uninvolved surrounding
tissue