The document discusses various types of malignant tumors that can occur in the jaws. It describes carcinomas such as squamous cell carcinoma arising in soft tissue, originating in bone, or originating in a cyst. It also discusses metastatic tumors that spread to the jaws from other sites, sarcomas such as osteosarcoma and chondrosarcoma, and malignancies of the hematopoietic system like multiple myeloma and lymphoma. For each type of tumor, it provides information on characteristics, clinical features, radiological features, signs and symptoms, and differential diagnosis. It also includes case reports and diagrams to illustrate radiological features of malignancy.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Cancer of the oral cavity accounts for approximately 3% of all malignancies diagnosed annually in 270,000 patients world-wide. Oral cancer is the 12th most common cancer in women and the 6th in men. Many oral squamous cell carcinomas develop from potentially malignant disorders (PMDs). Lack of awareness about the signs and symptoms of oral PMDs in the general population and even healthcare providers is believed to be responsible for the diagnostic delay of these entities.
This is a presentation describing in brief regarding the physics behind MRI and it's application from dental point of view. It contains few videos as well.
Benign, locally aggressive tumor of odontogenic epithelium, Previously called adamantinoma, Second most common odontogenic tumor after odontoma, Mandible is most common site, Usually asymptomatic and can be found incidentally on routine dental examinations
Hey Guys, this presentation is all that a BDS graduate needs to know. A very basic yet important facts about CBCT.
Stay Safe
Regards
Battisi - Dr. Jasmine Singh
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Cancer of the oral cavity accounts for approximately 3% of all malignancies diagnosed annually in 270,000 patients world-wide. Oral cancer is the 12th most common cancer in women and the 6th in men. Many oral squamous cell carcinomas develop from potentially malignant disorders (PMDs). Lack of awareness about the signs and symptoms of oral PMDs in the general population and even healthcare providers is believed to be responsible for the diagnostic delay of these entities.
This is a presentation describing in brief regarding the physics behind MRI and it's application from dental point of view. It contains few videos as well.
Benign, locally aggressive tumor of odontogenic epithelium, Previously called adamantinoma, Second most common odontogenic tumor after odontoma, Mandible is most common site, Usually asymptomatic and can be found incidentally on routine dental examinations
Hey Guys, this presentation is all that a BDS graduate needs to know. A very basic yet important facts about CBCT.
Stay Safe
Regards
Battisi - Dr. Jasmine Singh
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Benig tumors of jaw/certified fixed orthodontic courses by Indian dental acad...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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3. M.Ekram
Categories of malignant
tumors
Carcinomas (lesions of epithelial origin).
Sarcomas (lesions of mesynchymal origin).
Metastatic ( lesions from distant sites).
Malignancies of hematopoietic system.
Classification of malignant
tumors of the jaws
4. M.Ekram
Malignant tumors of the jaws
I. Carcinomas
Sq.cell.carcinoma arising in soft tissue
Sq.cell.carcinoma originating in bone
Sq.cell.carcinoma originating in a cyst
Central mucoepidermoid carcinoma
II. Metastatic tumors
6. M.Ekram
Characteristics of Malignant Tumors
Unlike benign tumors, they are :
More locally invasive
Have a a greater degree of anaplasia
( Loss of structural differentiation of the cells being more primitive with
Marked reproductive activity )
Have the ability to metastasize
M.Ekram
7. M.Ekram
Clinical features which suggest the
presence or malignancy
Swelling
Displaced teeth
Loosened teeth over a short duration
Ulceration
Presence of an ulcer with indurated or rolled
borders.
M.Ekram
8. M.Ekram
Foul smell
Exposure of underlying bone
Sensory or motor neural disorders
Lymphadenopathy
Weight loss
Clinical features which suggest
the presence or malignancy
10. M.Ekram
The following features may suggest
the presence of malignancy
I. Location
Primary carcinomas
Tongue , floor of the mouth , tonsillar area , lip ,
soft palate or gingiva.
M.Ekram
11. M.Ekram
Metastatic tumors
*Posterior mandible or maxilla
* Apex of a tooth or follicle of a
developing tooth
Sarcomas
* More in the mandible
* More in posterior region of both jaws
The following features may suggest the presence of malignancy
M.Ekram
12. M.Ekram
Malignant
Tumor
II. Periphery and shape
They grow by
invasion and
destruction of
surrounding bone
without cortical
expansion
M.Ekram
Radiologic features which suggest the
Presence of malignancy
13. M.Ekram
Ill defined irregular
borders with lack
of cortication or
encapsulaion.
This infiltrative border has uneven extensions of
bone destruction.
Finger-like extensions of the tumor in many
directions may be seen.
The following features may suggest the presence of malignancy
M.Ekram
15. M.Ekram
III. Internal structure
Typically radiolucent
in most instances.
May be residual
islands of bone.
The following features may suggest the presence of malignancy
M.Ekram
16. M.Ekram
Bone destruction may
be associated with
an adjacent soft tissue
mass.
The following features may suggest the presence of malignancy
RULE
Evidence of osseous destruction
with adjacent soft tissue mass is
highly suggestive of malignancy.
17. M.Ekram
Floating Teeth
Rapidly growing malignant lesions spreads Rapidly, destroying
the supporting alveolar bone but leaving the teeth in their
original position so the teeth appear floating often without
evidence of root resorption.
18. M.Ekram
Rapid invasion of the
periodontal ligament
space around the teeth
resulting in irregular
widening with destru-
ction of the lamina
dura.
Occasionally root resorption (more in sarcomas) .
The following features may suggest the presence of malignancy
19. M.Ekram
Some metastatic tumors
(prostate and breast)
can induce bone
formation whereas
others (osteogenic
sarcoma) can cause
frank sclerosis.
The following features may suggest the presence of malignancy (con)
20. M.Ekram
Where the tumor
destroys the outer
cortex of bone ,
usually no periosteal
reaction occurs.
The following features may suggest the presence of malignancy
21. M.Ekram
The presence of a malignant tumor growing near a
cortex tends to cause destruction and occasionally rapid
elevation of the bone-forming periostium, resulting in
bone specules resembling sunburst.
Malignant
Tumor
Sunburst appearance
22. M.Ekram
Lesions such as
osteosarcoma
and prostate
metastatic
carcinoma
can stimulate
thin straight specules of bone giving a
“sunburst” appearance.
The following features may suggest the presence of malignancy
27. M.Ekram
Multifocal lesions located at root apices and in the papilla
of a developing tooth destroying the crypt cortex and
displacing the developing tooth in an occlusal direction.
M.Ekram
28. M.Ekram
1. cortical bone destruction
without periosteal reaction.
2. Laminated periosteal reaction
with destruction of the cortical
bone and the new periosteal
Bone
3. Destruction of cortical bone
with periosteal reaction at the
periphery forming Codman’s
triangles.
4. Speculated or sunray type of
periosteal reaction.
M.Ekram
Four types of effects on cortical bone and periosteal reaction
31. M.Ekram
Squamous cell carcinoma
arising in soft tissue
A malignant tumor originating within the surface
epithelium. This malignant epithelium can invade
the underlying connective tissue , and occasionally
the adjacent bone and local regional lymph nodes.
32. M.Ekram
Age: over 50 years
Sex : more in males
Site : Soft tissues of the mouth.
Differential diagnosis: osteomyelitis.
Squamous cell carcinoma
arising in soft tissue
33. M.Ekram
Swelling
Displaced teeth
Loosened teeth over a short duration
Ulceration
Presence of an indurated or rolled borders.
Foul smell
Exposure of underlying bone
Sensory or motor neural disorders
Lymphadenopathy
Weight loss
Dysphagia
Dysphonia
Dysgeusia
Hemorrhage
Lack of normal healing
Pain with no demonstrable dental causeM.Ekram
signs and symptoms
34. M.Ekram
Signs and Symptoms
White or red (or mixed) patch that
ulcerates.
Swelling ,displaced teeth,
loosened teeth over a short
duration, Ulceration, Presence of
an indurated or rolled borders.
Foul smell, exposure of
underlying bone, Sensory or
motor neural disorders,
lymphadenopathy and
weight loss
35. M.Ekram
Radiologic features
Ill defined non corticated
radiolucency borders .
May be small island of
normal bone are observed.
Finger like extensions are
observed at the periphery.
36. M.Ekram
Radiologic features
Loss of lamina dura
and widening of the
periodontal membrane
with loosening of teeth.
Desruction of the
normal cortical
boundaries.
48. M.Ekram
Squamous cell carcinoma
originating in bone
(Primary intraosseos carcinoma)
It is a squamous cell carcinoma arising within the
jaw and that has no original connection with the
surface epithelium of the oral mucosa.
49. M.Ekram
Carcinoma in bone
Age: fourth to eighth decade
Gender: more in males
Differential diagnosis:
1. granuloma
2. odontogenic cyst or tumor
50. M.Ekram
Signs and Symptoms
May remain silent till it
reaches a fairly large size.
Pain and lip parasthesia.
Regional lymphadenopathy
Pathological fractures may
occur.
51. M.Ekram
Radiologic features
Round or irregular
radiolucency with ill or well
defined border.
Displacement of teeth.
Destruction of the normal
cortical boundary
Root resorption is unusual.
Regional lymphadenopathy
52. M.Ekram
Squamous cell carcinoma
originating in a cyst
(Epidermoid cell carcinoma )
An uncommon form of
squamous cell carcinoma
arising in a preexisting
dental cyst. They may arise
from inflammatory
periapical , residual ,
dentigerous , and
odontogenic keratocysts.
53. M.Ekram
Signs and Symptoms
Site: more in the mandible .
Dull pain lasting for several
months.
Swelling and may be facial
disfigurement.
Regional lymphadenopathy.
In maxilla sinus pain and / or
swalling may occur.
54. M.Ekram
Radiologic features
Round or oval radiolucency.
Early has well defined borders
but later become ill- defined.
Thining and desruction of the
lamina dura of teeth or adjacent
cortical boudaries.
Destruction of the alveolar
process.
55. M.Ekram
Central mucoepidermoid
carcinoma
( mucoepidermoid carcinoma )
It is an epithelial tumor arising in bone. It is
believed to derive from the salivary duct system.
The criteria for diagnosis include:
the presence of intact cortical plates
radiographic evidence of bone destruction
histologic features of mucoepidermoid tumors
56. M.Ekram
Site : more in mandible (2:1)
Sex : more in females
Differential Diagnosis:
1.Odontogenic myxoma
2. Central giant cell granuloma
3. Odontogenic cyst or tumor
Signs and Symptoms
57. M.Ekram
Signs and Symptoms
painless swelling that lasts
for months or even years
causing facial asymmetry.
Tenderness may occur.
Parasthesia of the inferior
alveolar nerve.
The lesion may spread to
the regional lymph nodes.
58. M.Ekram
Radiologic features
An expansile unilocular or
multilocular radiolucent lesion with
a soap bubble or honeycomb
appearance.
Borders are well defined and
corticated but rarely not corticated
and has a malignant appearance.
Expansion of the adjacent normal
bone.
Teeth remain unaffected although
their adjacent lamina dura is lost.
59. M.Ekram
Malignant ameloblastoma and
ameloblastic carcinoma
An ameloblastoma exhibiting the
histologic criteria of a malignant neoplasm
such as increased and abnormal mitosis
and hyperchromatic , large nuclei.
60. M.Ekram
Age : first to sixth decade
Sex : more in males
Site : more in mandible
(molar and premolar
regions))
Signs and Symptoms
61. M.Ekram
Signs and Symptoms
A hard expansile mass
of the jaw with displaced
and perhaps loosened
teeth.
Tenderness of the
overlying soft tissue.
62. M.Ekram
Signs and Symptoms
Local extension may
occur into adjacent
bones, connective tissue
or salivary glands.
Metastasis may spread
to cervical lymph nodes,
lung, viscera or spine.
63. M.Ekram
Radiologic features
Similar to benign
ameloblastoma but with
more invasion and
destruction of the cortical
boundaries.
Teeth may be displaced
with root resorption as in
benign ameloblastoma
72. M.Ekram
Metastatic tumors
(General metastatic tumors)
Metastatic tumors represent the
establishment of new foci of malignant
disease from a distant malignant tumor
(primary lesion). Metastasis involve the jaw ,
skull , spine , pelvis , ribs and humerous.
Most common primary sited include the
prostate , kidney , thyroid , , breast , and
lung.
73. M.Ekram
Metastatic tumors
Age : fifth to seventh
decade
Sex : males and females
Site : more in mandible,
may be bilateral
(more in posterior region of
both jaws)
In maxilla , max.sinus,
hard palate, mandibular
Condyle, periodontal
ligament and papillae of
developing teeth.
74. M.Ekram
Signs and Symptoms
Dental pain
Numbness of the
mandibular nerve.
Pathological fracture of
the jaws.
Haemorrhage from the
tumor site.
76. M.Ekram
Radiologic features
May start as small zones
(Multifocal)separated by normal
bone that coalesce forming a
large ill defined lesion.
The lesion is generally radiolucent
but may be with islands of
residual normal bone.
Prostate and breast metastasis
may show areas of patchy
sclerosis i.e. bone formation.
77. M.Ekram
Radiologic features
Tooth crypts may be
destroyed and extraction
sockets failto heal and
increase in size.
Teeth may appear floating.
Destruction of the adjacent
structures as IAC,
max.sinus or nasal fossa.
Sometimes the tumor
breaches the cortical plate
and present as an intraoral
mass.
81. M.Ekram
Osteosarcoma
(Osteogenic sarcoma)
Osteosarcoma is a malignant neoplasm of
bone in which osteoid is produced directly by
malignant stroma.
N.B. It is also known to occur in association
with Paget’s disease and fibrous dysplasia
after theraputic irradiation.
82. M.Ekram
Age : peak in fourth decade
Sex : more in males (2:1)
Site : more in mandible
(more in posterior region)
Osteosarcoma
(Osteogenic sarcoma)
84. M.Ekram
Signs and Symptoms
Hypoesthesia if the
neurovascular canals
are involved.
Epistaxis, hemorrhage,
nasal obstruction,
exophthalmos, trismus
and blindness.
85. M.Ekram
Radiologic features
The lesion is usually
radiolucent with no sclerosis
or encapsulation and has ill
defined margins.
Widening of the PL space.
If the lesion involves the
periostium directly or by
extension and when the
periostium is partially
destroyed sunray specules or
hair-on-end specules may be
seen.
90. M.Ekram
Age : any age (adults mean 47)
Sex : males = females
Site :
1. in bone , bone periphery but less common in soft
tissue.
2. In cartilage or within benign cartilagenous tumor (2ry
chondrosarcoma)
Chondrosarcoma
(Chondrogenic sarcoma)
91. M.Ekram
Signs and Symptoms
Firm or hard mass of relatively long duration.
Enlargement of the lesion may cause pain, and
facial deformity.
Less frequently hemorrhage from the tumor or
necks of teeth, sensory nerve deficits, proptosis
and visual disturbances.
92. M.Ekram
Signs and Symptoms
The lesion is covered by
normal skin or mucosa
unless secondarily
ulcerated.
Trismus or abnormal
TMJ function may occur
if the lesion occurs near
the TMJ region.
93. M.Ekram
Radiologic features
The lesion is generally round,
ovoid or lobulated.
Borders are commonly well
defined but less commonly ill
defined and invasive.
The lesion is commonly mixed
RL / RP with sunray
appearance (hair-on-end) and
rarely radiolucent.
94. M.Ekram
Radiologic features
The radiopaque structure is
described as flocculent
implying snow-like features.
A ground glass appearance
is sometimes observed.
Expansion of the cortical
boundaries rather than
destroying them.
Tooth displacement, root
resorption and widening of the
periodontal membrane may
occur.
96. M.Ekram
Ewing’s sarcoma
(Round cell sarcoma)
It is a tumor of long bones and is relatively
rare in the jaws. Lesions arise in the
medullary portion of the bone and spread to
the endosteal and later periosteal surfaces.
97. M.Ekram
Age : second decade
(5 – 30 y)
Sex : males more than
females (2 – 1)
Site : mandible more than
maxilla & more in the
posterior region
N.B the lesion is rare in the
jaws.
Ewing’s sarcoma
(Round cell sarcoma)
99. M.Ekram
Radiologic features
Round or ovoid
radiolucency that is poorly
demarcated , ill defined and
never corticated.
The lesion is solitary and
pathological fractures may
occur.
100. M.Ekram
Radiologic features
The lesion abuts teeth or
tooth follicles with
destruction of their cortices.
This tumor doesn’t cause
root resorption but destroys
the supporting bone of the
adjacent teeth.
Bone formation may occur
but it is not a common
feature.
106. M.Ekram
Multifocal lesions located at root apices and in the papilla of a
developing tooth destroying the crypt cortex and displacing the
developing tooth in an occlusal direction.
M.Ekram
116. M.Ekram
Fibrosarcoma
It is a neoplasm composed of malignant
fibroblasts that produce collagen and elastin.
Fibrosarcoma is of unknown etiology but
may develop following radiotherapy.
117. M.Ekram
Age : fourth decade (as a mean)
Sex : males and females equally
Site : mandible more in the premolar - molar
region
N.B the lesion is rare in the jaws.
Fibrosarcoma
118. M.Ekram
Signs and Symptoms
Rapidly enlarging mass may be within the bone in
which case it is acompanied with pain.
The lesion involves local soft tissues causing a
bulky lesion.
The overlying mucosa may become erythematous
or ulcerated.
Trismus may be due to involvement of the TMJ or
paramandibular structures.
119. M.Ekram
Radiologic features
The lesion is radiolucent with ill
defined non corticated borders
borders.
The lesion may invade the bone
or produce a saucer shaped
depression in it.
It destroys the adjacent
structures, and cause
displacement or loosening of
teeth but root resorption is
uncommon.
120. M.Ekram
Radiologic features
Widening of the periodontal
membrane space.
Codman’s triangles or
sunray appearance may be
evident if the lesion disturbs
the periostium.
123. M.Ekram
Multiple myeloma
(Plasma cytoma)
It is a malignant neoplasm of plasma cells. It
is the most common malignancy of bone in
adults.
Single lesions are called Plasmacytoma and
multiple lesions are termed Multiple
myeloma.
124. M.Ekram
Age : 35 to 70 years (mean age 60 years)
Sex : more in males
Site : mandible more than the maxilla.
*in the mandible it occurs in the body and ramus
regionspremolar - molar region
*In the maxilla it occurs in the posterior region
N.B the lesion is rare in the jaws.
Multiple myeloma
(Plasma cytoma)
125. M.Ekram
Signs and Symptoms
Fatigue, weight loss, fever, bone
pain, anemia and low back pain.
Dental pain is uncommon, swelling,
hemorrhage, parasthesia,
dysesthesia or the patient has no
complaint.
Amyloidosis, hypercalcemia and
Bence Jones protein in urine.
126. M.Ekram
Radiologic features
Generally the lesions are oval
or cystic and may be multiple
giving a multi focal
appearance.
The individual lesions are
punched out with well defined
borders but not corticated.
Islands of residual bone may
be seen in the internal structure
of the giving the appearance of
new bone.
127. M.Ekram
Radiologic features
Periosteal reaction is
uncommon with the result a
single radiopacity or even
sunray appearance.
The teeth are loose and the
cortical boubdaries are
destroyed.
Other bones may be
involved as the skull,
pelvice ,ribs and humerus.
129. M.Ekram
Non-Hodgkin’s lymphoma
(Lymphosarcoma)
It is a malignant tumor of cells normally
resident in the lymphatic system.
Lymphomas occur within lymph nodes.
Extranodal sites include bone , skin , GIT
mucosa and tonsils.
130. M.Ekram
Age : All ages except the first decade 0f life.
Sex : both
Site : Lymph nodes, maxilla ,maxillary sinus,and
posterior mandible.
Non-Hodgkin’s lymphoma
(Lymphosarcoma)
131. M.Ekram
The Pt feel unwell with
night sweat, pruritis and
weight loss.
A palpable painless
swelling is noted with
lymphadenopathy ans
sensorineural deficits.
Lesions may cause pain
and ulceration.
Teeth may become mobile
due to bone destruction.
Signs and Symptoms
132. M.Ekram
Unilocular or multilocular
radiolucency with ill defined and
invasive border.
The tumor may grow in the
periodontal ligament space with
diplacement of teeth.
When located in the developing
papilla the developing teeth are
displaced in an occlusal
direction.
Radiologic features
136. M.Ekram
Burkitt’s lymphoma
It is a high - grade B-cell lymphoma that
differs from other B-cell lymphomas with
respect to it’s histologic appearance and
clinical behavior.
137. M.Ekram
Age : any age, children and
adults in their 7th
decade.
Sex : males more than
females
Site :
* African type may involves
the posterior region of one
or both jaws.
*American type affects the
abdominal viscera and
testes
Burkitt’s lymphoma
138. M.Ekram
Gros facial deformity and facial
swelling with obstruction of the
nasal passages and
displacement of the orbital
contents.
The lesion may erode the skin.
Loosening of teeth.
Parasthesia of the IA nerve and
other sensory facial nerves.
Signs and Symptoms
139. M.Ekram
The lesion may begin as
multiple ill-defined , non
corticated radiolucencies that
coalesce to form a larger ill
defined radiolucency with
expansile periphery.
Displacement of the orbital
contents if the lesion involves
the orbit.
Radiologic features
140. M.Ekram
Thinning of adjacent
structures and formation
of a soft tissue mass
adjacent to the osseous
defect.
Destruction of the lamina
dura and cortical
boundaries with
loosening of teeth.
Radiologic features
142. M.Ekram
Leukemia
Leukemia is a malignant neoplasm of
hematopoitic stem cells. These malignant
cells displace normal bone marrow
constituents and spill out into the
peripheral blood. They are subdivided into
acute and chronic leukemias and further
subdivided by the cell of origin i.e.
Myelogenous, Lymphatic and Monocytic.
143. M.Ekram
Pt’s with chronic leukemia may have no signs.
Pt’s with acute leukemia have :
Pt feel unwell with weakness and bone pain.
Fever, pallor and spontaneous hemorrhage.
Hepatomegally, splenomegally and
lymphadenopathy.
Oral symptoms (if present) include loose teeth,
petechia, gingival bleeding, ulceratin and
enlarged gingiva.
Signs and Symptoms
144. M.Ekram
The lesion may begin as
multiple ill-defined , non
corticated radiolucencies that
coalesce to form a larger ill
defined radiolucency and
granular bone may be seen
within the lesion.
The periodontal structures
are affected and the teeth
with loss of the alveolar bone
around the teeth.
Radiologic features
146. M.Ekram
Causes of death in oral malignancy
Metastasis to the brain (brain stroke).
Metastasis to the heart and blood vessels
(thrombosis and embolism).
Metastasis to the lung (aspiration pneumonia
, respiratory obstruction).
147. M.Ekram
Causes of death in oral malignancy
Metastasis to the liver (liver cirrhosis , hepatitis
and affection of body metabolism).
Bone marrow (anemia, leukopenia,
agranulocytosis, thrombocytopenia and
inhibition of the immune system).
Tumors in the throat area (dysphagia and
suffocation).