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Soft Tissue Lesions - Coggle Diagram
Soft Tissue Lesions
Soft Tissue Neoplasms
Fibrosarcoma
- Etiology: Maybe linked to pervious radiation therapy and tissue trauma.
- Method of Transmission: Not applicable.
- Characteristics: Gradually enlarging, painless masses. May complain of pain, swelling, paresthesia ,and loosening of teeth.
- Dental Implications: Early detection if of utmost important.
- Treatment and Prognosis: Surgical excision with wide margins. Prognosis is guarded. 5 year survival rate is 50% to 70%.
- Citation: Delong, Burkhart textbook, pg 408
Neoplasms of Fat Tissues
Liposarcoma
- Etiology: Benign neoplasms of adipose cells. Unknown.
- Method of Transmission: Not applicable.
- Characteristics: Rarely found in the oral cavity. Superficial smooth-surfaced, soft palpable mass that imparts a yellowish color to the overlying mucosa.
- Dental Implications: Documentation, early detection and definite diagnosis.
- Treatment and Prognosis: Surgical excision. Prognosis is normally good. Tumor can recur and prognosis becomes less favorable.
- Citation: Delong, Burkhart textbook, pgs 411-412
Lipoma
- Etiology: Benign neoplasms of adipose cells. Unknown.
- Method of Transmission: Not applicable.
- Characteristics: Superficial smooth-surfaced, soft palpable mass that imparts a yellowish color to the overlying mucosa. Buccal mucosa is the most common site. More often in adults around age 50.
- Dental Implications: Documentation and definite diagnosis.
- Treatment and Prognosis: Surgical removal. Recurrent is not a factor.
- Citation: Delong, Burkhart textbook, pgs. 411-412
Salivary Gland Neoplasms
Minor Salivary Gland
Polymorphous Low-Grade Adenocarcinoma
- Etiology: Maybe associated with genetic mutations and the over-production of specific gene products such as p63.
- Method of Transmission: Not applicable.
- Characteristics: Hard and soft palate is the most common site. slow-growing, smooth-surfaced, painless mass that may exist for years.
- Dental Implications: One of the first signs might be a denture that starts to feel uncomfortable. All patients who wear dentures should be encouraged to have periodic oral examinations to detect abnormalities at early stage.
- Treatment and Prognosis: Surgical excision with wide margin. Local recurrence has been reported. Metastasis is uncommon.
- Citation: Delong, Burkhart textbook, pgs 416-417.
Adenoid Cystic Carcinoma
- Etiology: Unknown. Some association with mutation on chromosomes 6 and 12 and delegation of genetic material from chromosome 19.
- Method of Transmission: Not Applicable.
- Characteristics: Intraoral lesions often manifest with pain as an early symptom. Parotid gland tumors are firm., well-defined masses within the gland. Slow growing and may be tender to palpation.
- Dental Implications: All dental procedures need to be completed before radiation therapy. Instruct the patient on long-term management of xerostomia and other oral side effects of radiation.
- Treatment and Prognosis: Surgical excision with wide margins and radiation therapy.
- Citation: Delong, Burkhart textbook, pg 417
Papillary Cystadenoma Lymphomatosum (Warthin Tumor)
- Etiology: Unknown.
- Method of Transmission: Not applicable.
- Characteristics: Usually bilateral. Tinnitus, pain in the ear, and deafness depending upon the stage of growth. Slow-growling, rubbery or firm, painless masses usually found in the tail of the parotid gland near the angle of mandible.
- Dental Implications: Extraoral and perioral palpations. Smoking cessation.
- Treatment and Prognosis: Surgical removal of tumor. Prognosis is excellent. There is chance of recurrence, if patient smokes. Rare reports of malignant transformation within the tumors.
- Citation: Delong, Burkhart textbook, pg 414
Mucoepidermoid Carcinoma
- Etiology: Unknown.
- Method of Transmission: Not Applicable
- Characteristics: Most often found in the parotid gland. Exist several years before reported. Longer the tumor present, more likely that symptoms of pain and facial nerve paralysis will develop.
- Dental Implications: Oral cancer screening examinations should include palpations of all of the major salivary gland to identify abnormalities at an early stage.
- Treatment and Prognosis: Surgical removal. If metastasis, lymph nodes in the neck may have to be removed. Postsurgical radiation is often indicated.
- Citation: Delong, Burkhart textbook, pg 415
Pleomorphic Adenoma (Benign Mixed Tumor)
- Etiology: Proliferations of two different types of salivary gland cells, ductal and myoepithelial.
- Method of Transmission: Not Applicable.
- Characteristics: Affects parotid gland more often. Painless, slow-growing, firm mass, usually found in the lower superficial lobe of the parotid near the angle of mandible. They are mobile when found in soft tissues but not mobile when found on the palate.
- Dental Implications: Difficult to remove. Monitor the patients for periodically for recurrence.
- Treatment and Prognosis: Complete surgical removal. Prognosis is excellent, Can result in significant morbidity due to extensive growth or in malignant transformation.
- Citation: Delong, Burkhart textbook, pgs 412-413
Acinic Cell Carcinoma
- Etiology: Unknown.
- Method of Transmission: Not Applicable.
- Characteristics: slow-growing hard masses. Facial nerve paralysis occurs infrequently. Pain can be a symptom not matter where the tumor is located.
- Dental Implications: Periodic oral examination and Oral cancer screening. Early detection.
- Treatment and Prognosis: Surgical excision depending on the location. Parotid gland involvement results in partial or total removal of the gland. Prognosis is generally good. 5-year survival rate is 90%. 20 year survival rate is 55%.
- Citation: Delong, Burkhart textbook, pgs 416-417
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Neurilemmoma (Schwannoma)
- Etiology: Proliferation of the Schwann cells of the nerve sheath.
- Method of Transmission: Not applicable.
- Characteristics: Smooth-surfaced submucosal masses. Most frequently on the tongue. Can occur within the bone.
- Dental Implications: Accurate interpretation of radiographic findings in areas where a patient reports pain and or paresthesia may be essential to detect this neoplasm, when it arises in bone.
- Treatment and Prognosis: Surgical excision. Little chance of recurrence or with malignancy so the prognosis is excellent.
- Citation: Delong, Burkhart textbook, pgs 408-409
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Neurofibroma
- Etiology: Originates from Schwann cells/ or connective tissue cells that support the peripheral nerves.
- Method of Transmission: Not applicable.
- Characteristics: Slow-growing, smooth surfaced mass. Most commonly on tongue or buccal mucosa. Can affect skin, and GI tract.
- Dental Implications: Detect lesions and request referral of the patient for a medical evaluation.
- Treatment and Prognosis: Surgical excision. Little chance of recurrence and prognosis is excellent.
- Citation: Delong, Burkhart textbook, pgs 409-410
Fibromatosis (Desmoid Tumor) (DTF)
- Etiology: Unknown. Maybe associated with mutation of the cell's DNA or disruption of another defense.
- Method of Transmission: Inherited conditions.
- Characteristics: Slowing enlarging tissue mass when observed in the oral cavity. Soft tissues around the mandible are commonly affected.
- Dental Implications: Early detection is crucial. Provide examinations which can identify abnormal growths.
- Treatment and Prognosis: Aggressive surgical excision with wide margins, anti-inflammatory medication, chemotherapy, and radiation therapy. Death have been reported because of recurrence. There is no metastasis.
- Citation: Delong, Burkhart textbook, pgs 407-408
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Infections
Bacterial Sialadenitis
- Etiology: Staphylococcus aureus, Streptococcus viridans, Streptoccocus pneumonia, and Haemophilus influensa.
- Method of Transmission: Not transmitted from person to person.
- Characteristics: Inflammation of the salivary ducts and the presence of purulent exudate. Fever malaise, and headache. Trismus is common.
- Dental Implications: Xerostomia is one of the major risk factors. Patients should be monitored closely.
- Treatment and Prognosis: Exudate needs to be cultured to determine specific bacteria for prescribing antibiotics. Analgesics are used to help decrease pain and moist compress, rehydration, and stimulation of salivary flow. Prognosis is good. Sometimes, it can extend into the tissues surrounding the gland and cause the spread of the infection into the neck or ear.
- Citation: Delong, Burkhart textbook, pgs 405
Mumps (Viral Sialadenitis)
- Etiology: Paramyxovirus
- Method of Transmission: Direct contact with saliva or saliva droplets of an infected person.
- Characteristics: Presence of swelling of the salivary gland, in addition to the systemic manifestations with viral infections. Orchitis and oophoritis.
- Dental Implications: It is important to recognize the manifestations of this infection so that the patient can be referred for medical evaluation.
- Treatment and Prognosis: Focused on relieving the general symptoms associated with a viral infection and includes bed rest, plenty of fluids, and analgesics for pain and fever. Prognosis is excellent.
- Citation: Delong, Burkhart textbook, pgs 404-405
Immune System Disorders
Sjogren Syndrome
- Etiology: Autoimmune.
- Method of Transmission: Not applicable.
- Characteristics: Triad manifestation of rheumatoid arthritis, xerostomia, and keratoconjunctivitis.
- Dental Implications: Xerostomia increases the patient's risk for dental caries, periodontal disease, and infections such as candidiasis. Patients should be periodically monitored for neoplastic changes in the parotid gland.
- Treatment and Prognosis: Artificial saliva and tears, extensive use of fluoride for caries prevention, and home care and diet modifications. Prognosis is normally good.
- Citation: Delong, Burkhart textbook, pgs 405-407