Benign tumors

By Dr. Vishaal Bhat on Sunday, 4 November, 2007 with 0 comments

Benign tumors of the oro-facial area grow from soft and hard tissues, including odontogenous tissues. They can be by no means underestimated since they may transform into malignant tumors or destroy the original organ and its vicinity by an expansive growth. Vascular tumors posses a danger of excessive bleeding. Based on the tissue of origin, these tumors can be divided into epithelial, mesenchymal and odontogenous.

  1. Benign epithelial tumors grow from the mouth or salivary glands epithelium. Most often, a papilloma occurs as exophytically growing, sometimes pedicled structure on the mucous membranes of the cheeks, tongue and palate. Multiple papillomatosis of the palate or cheeks may occur as well. The verruca (a wart) on the face skin belongs to the same group. Therapy of these tumors is surgical. An adenoma grows from the epithelium of salivary glands. Based on their histological composition, they are mostly mixed tumors - pleomorphic adenomas, or there can be monomorphic adenomas composed of cells of one type (adenolymphoma, oxyphillic adenoma). Also for these tumors, the only appropriate therapy is the surgical removal.

  2. Benign mesenchymal tumors originate from various tissues of the facial area. Based on histological composition, they classify as fibromas, lipomas, myomas, angiomas, lymphangiomas, osteomas, and tumors of neurogenic origin. They manifest commonly as bordered structures of various texture, growing slowly inside the oral cavity. If they grow inside the bony tissue, they result in deformation of the jawbones (osteomas, intra-osseal fibromas). A formation that sits on an alveolar ridge near a tooth appears quite frequently inside the mouth - epulis. It has to be removed surgically, followed sometimes by extraction of a tooth in which vicinity it grows. Hemangiomas (capillary or cavernous forms) grow slowly inside the oral cavity; they may be wounded by a hard food which results in bleeding. Hemangiomas appear also on the skin of face together with the inherited vascular anomaly - naevus flammeus. In case of haemangiomatosis faciei, large angiomas penetrate into the jawbones from soft tissues, making a surgery complicated. For therapy of small hemangiomas of the oral mucosa, a cryo-destruction, sclerotization (injection of Aethoxysklerol) and surgical extirpation are often used with a good success. In cases of extensive facial angiomatoses, a pre-operational selective micro-embolization of supplying vessels by small plastic spirals or globules is used. The subsequent surgery then results in smaller blood losses.

  3. Odontogenous tumors originate from the primitive dental epithelial strip which is the basis of dental tissues during development. Based on contribution of a particular component, tumors are categorized as epithelial, mesenchymal and mixed. One of the most prominent epithelial odontogenous tumors is the ameloblastoma (adamantinoma, multi-locular cystoma). It appears mainly at the lower jawbone around the angle, it has mostly a cystic form and it deforms the mandible and makes it thinner by its expansive growth. An X-ray examination reveals a picture of a multi-ocular cyst with thin partitions. However, solid forms exist, too. Therapeutic surgery has to be radical since when not removed completely, this tumor recurs and tends to become malignant (malignant ameloblastoma). Out of all mesenchymal odontogenous tumors, the cementoma has to be mentioned. It is created by proliferation of cementoblasts of the periodontal membrane. On an X-ray image it appears as homogenous, surrounded shadow around a tooth’s root. The soft odontomas, odontoblastomas and hard odontomas belong among the mixed odontogenous tumors. All these odontogenous tumors should be removed surgically.

Category: Stomatology Notes



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