Classify Non-Odontogenic Tumors Of Oral Cavity

Non-Odontogenic Tumors Of Oral Cavity

Epithelial Tissue

Epithelial Tissue Benign tumors

• Papilloma
• Keratoacanthoma
• Squamous acanthoma
• Nevus

Epithelial Tissue Malignant tumors

• Squamous cell carcinoma
• Mucoepidermoid carcinoma
• Adenocarcinoma
• Basal cell carcinoma
• Transitional cell carcinoma
• Melanoma
• Verrucous carcinoma
• Intraepidermoid carcinoma

 

Fibrous Connective Tissue Benign tumors

• Fibroma
• Fibrous hyperplasia
• Fibrous epulis
• Giant cell firoma
• Myxoma
• Myxofiroma.

Fibrous Connective Tissue Malignant tumors

• Fibrosarcoma

Cartilage Tissue

Cartilage Tissue Benign tumors

• Chondroma
• Chondroblastoma
• Chondromyxoid firoma.

Cartilage Tissue Malignant tumors

• Chondrosarcoma

Adipose Tissue

Adipose Tissue Benign tumors

• Lipoma
• Angiolipoma.

Adipose Tissue Malignant tumors

• Liposarcoma

Bone

Bone Benign tumors

• Osteoma
• Osteoid osteoma
• Osteoblastoma

Bone Malignant tumors

• Osteosarcoma
• Osteochondrosarcoma

Vascular Tissue

Vascular Tissue Benign tumors

• Hemangioma
• Hereditary hemorrhagic telangiectasia
• Lymphangioma

Vascular Tissue Malignant tumors

• Hemangioendothelioma

Neural Tissue

Neural Tissue Benign tumors

• Neurofibroma
• Neurilemmoma
• Schwannoma

Neural Tissue Malignant tumors

• Neurosarcoma
• Neurofirosarcoma

Muscles

Muscles Benign tumors

• Leiomyoma
• Rhabdomyoma

Muscles Malignant tumors

• Leiomyosarcoma
• Rhabdomyosarcoma

Giant Cell Tumor

• Central and peripheral giant cell tumor
• Giant cell granuloma
• Giant cell tumor of hyperthyroidism.

Teratoma

Salivary Gland Tumor

Salivary Gland Tumor Benign tumors

• Adenoma
• Warthin’s tumor
• Pleomorphic adenoma.

Salivary Gland Tumor Malignant tumors

• Mucoepidermoid carcinoma
• Adenocystic carcinoma
• Adenocarcinoma
• Acinic cell carcinoma
• Malignant change in pleomorphic adenoma

Lymphoid Tissue

Lymphoid Tissue Malignant tumors

• Hodgkin’s and non-hodgkin’s lymphoma
• Lymphosarcoma
• Reticular cell sarcoma
• Ewing’s sarcoma
• Burkitts lymphoma
• Multiple myeloma
• Leukemia.

Lymphoid Tissue Malignant melanoma

Malignant melanoma is a neoplasm of epidermal melanocytes.
It is the third most common cancer of the skin.

Lymphoid Tissue Etiology

• Sun exposure: Persons who are exposed to the excess of sunlight develops malignant melanoma.
• Artifial UV source: PUVA thearpy has been reportedly associated with risk of melanoma.
• Socioeconomic status: It is seen in high socioeconomic status since people of high socioeconomic status go for holidays.
• Fare skin, freckles, red hair: These characteristics increased the risk of melanoma.
• Melanotic nevi are the strong risk factors.
• Genetic factors: Familial melanoma and xeroderma pigmentosum are considered to be strong genetic factors for development of malignant melanoma.

Clinical types of Malignant Melanoma

• Superficial spreading melanoma: Exists in a radial growth phase. Lesion present as tan, brown or black admixed lesion on sun exposed skin. Radial growth phase may last for several months to years.
• Nodular melanoma: It exists in a vertical growth phase. It present sharply delineated nodule with varying degrees of pigmentation. They may be pink or black.
• Lentigo maligna melanoma: Exists in a radial­growth phase. The lesion occur as macular lesion on malar skin of Caucasians.
  Acral lentiginous melanoma: Melanoma developing on the palms and soles as well as toe and figers. It is characterized by macular lentiginous pigmented area around nodule.
• Mucosal lentiginous melanoma: Develops from mucosal epithelium that lines respiratory, gastrointestinal and genitourinary systems. It is more aggressive.
• Amelanotic melanoma: It is an erythematous or pink sometimes eroded nodule.

Malignant Melanoma Clinical Features

• Oral melanomas initiate as macular pigmented focal lesions.
• Most of the lesions are pigmented excepting few non­pigmented lesions which referred to as “amelanotic melanomas”, which appear as “slightly” inflamed looking areas.
• Pigmented lesions are often dark­brown, bluish­black or simply black in appearance.
• Initial macular lesions grow very rapidly and often result in a large, painful, diffse mass.
• Surface ulceration is very common and beside; this, hemorrhage, paresthesia and superficial fungal infections are often present.
• As the tumor continues to grow, small satellite lesions can develop at the margin of the primary tumor.
• Like other epithelial malignant tumors, melanomas exhibit litte or no induration at the periphery.
• Oral melanomas often cause rapid invasion and extensive destruction of bone. This often results in loosening and exfoliation of the regional teeth in the jaw.
• Widespread dissemination of the tumor cells occurs frequently in the lymph nodes as well as in the distant sites,e.g. the lung, liver, bone and brain, etc.

Malignant Melanoma Histopathology

• Microscopically the malignant cells lie in nest or cluster of groups in an organoid fashion.
• Melanoma cells have large nuclei, often with prominent nucleoli and show nuclear pseudoinclusion.
• Cytoplasm of the cell is abundantly eosinophilic or optically clear.
  There is presence of large, epithelioid melanocytes distributed in pagetoid manner.
• When melanocytes penetrate the basement membrane a flrid host cell response of lymphocytes develop.
• Macrophages or melanophages may be present.
• Vertical growth phase is characterized by the proliferation of malignant epithelioid melanocytes in the underlying connective tissues.
• These malignant melanocytes often exhibit extensive cellular pleomorphism and nuclear hyperchromatism.
• However, in some lesions melanin production by the tumor cells can be very little and on few occasions there can be virtually no melanin production.

Malignant Melanoma Treatment

• Radical surgery with prophylactic neck dissection is often advised.