Bailey's Chapter 112 - Odontogenic Cysts Tumors

11 Questions | By Resident | Last updated: Mar 21, 2022 | Total Attempts: 492

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Multiple choice quiz based on Bailey's 4th ed. Otolaryngology Head and Neck Surgery Chapter 112: Odontogenic Cyts, Tumors, and Related Jaw Lesions

Questions and Answers

1.

A 14yo M presents with assymetrical swelling of his lower jaw. It is non-tender and has been progressively assymetric for the last year at least. On physical exam all cranial nerves are intact. His occlusion is minimally displaced. A CT Scan of a representative sample is shown below. Which of the following would be the best treatment option?
- A.
  
  Observation with close follow up
- B.
  
  Segmental resection of the mandible with postoperative radiation
- C.
  
  Recontouring of the jaw surgically and orthodontics to correct malocclusion
- D.
  
  Enucleation of the cyst with osseocurretage
2.

Unfortunately, the same child as above incorrectly undergoes segmental resection of the mandible one week later and we have the following histo slide to look at from the pathology. A characterisitic H&E stain of the specimen is shown below. The report indicates that the borders of the specimen are difficult to interpret due to surigical distortion (cutting) at the edges. Which of the following statements regarding this disease is FALSE?
- A.
  
  The specimen exibits curvilinear portions of woven bone, sithout appositional osteoblasts, in a background of connective tissue stroma.
- B.
  
  The patient is at an increased risk for sarcomatous transformation of the disease
- C.
  
  The patient is likely to have other similar lesions in his longbones over the course of his life
- D.
  
  Appropriate treatment would have been delayed contouring of the jaw after final growth has occurred.
- E.
  
  This disease is a sporadic mutation in the alpha-subunit of a signal transducing G-protein
3.

A middle aged male is seen for a slowly growing mass. It is located in the posterior portion of the mandible. It is asymptomatic and does not alter the sensory nerve function of the patient. Radiographically, the lesion is multilocular, with ill-defined borders. Histologically the specimen is seen below. What is the correct diagnosis?
- A.
  
  Odontogenic Myxoma
- B.
  
  Adenocarcinoma
- C.
  
  Ameloblastoma
- D.
  
  Odontogenic Keratocyst
- E.
  
  Adenomatoid Odontogenic Cyst
4.

An 18yo F presents with the following: . She undergoes enucleation and curretage. Pathology demonstrates:What is the correct diagnosis?
- A.
  
  Odontogenic Myxoma
- B.
  
  Adenocarcinoma
- C.
  
  Ameloblastoma
- D.
  
  Odontogenic Keratocyst
- E.
  
  Adenomatoid Odontogenic Cyst
5.

Unlike fibrous dysplasia, ossifying fibromas are true tumors of mesenchymal origin that have strong predilection for the tooth-bearing portion of the jaws. Which of the following statements ARE TRUE regarding these tumors (select 2)?
- A.
  
  Their radiologic appearance is similar throughout the life of the disease process
- B.
  
  In the mandible, they typically appear as a midbody growth at the medial border.
- C.
  
  The juvenile form is more common and is benign
- D.
  
  The juvenile form has a predilection for the maxilla
- E.
  
  It is usually well demarcated
6.

Which of the following is the most common inflammatory cyst?
- A.
  
  Dentigerous Cyst
- B.
  
  Odontogenic Keratocyst
- C.
  
  Radicular Cyst
- D.
  
  Nasopalatine Duct Cyst
- E.
  
  Stafne Bone Cyst
7.

A 45yo F presents with swelling of the upper lip, pain on the maxilla, as well as sensitivity to cold. A CT scan is obtained. What is the correct diagnosis?
- A.
  
  Periapical cyst
- B.
  
  Dentigerous Cyst
- C.
  
  Odontogenic Keratocyst
- D.
  
  Nasopalatine Duct Cyst
- E.
  
  Stafne Bone Cyst
8.

A 24yo M comes to clinic for chronic postnasal drip. He has a frequent cough because of this. He has attempted many over the counter antihistamines with limited success. A referral to an allergist was made and after a negative skin test the following CT scan was obtained. He is referred to you for treatment of his sinusitis. What is the likely diagnosis?
- A.
  
  Dentigerous Cyst
- B.
  
  Nasopalatine Duct Cyst
- C.
  
  Stafne bone Cyst
- D.
  
  Fibroosseous Dysplasia
- E.
  
  Radicular cyst
9.

Which of the following helps to separate a dentigerous cyst from an odontogenic keratocyst?
- A.
  
  Amyloid deposition
- B.
  
  Rushton bodies
- C.
  
  Unerupted teeth
- D.
  
  Ghost cells
- E.
  
  Cortical expansion
10.

A 30yo M presents for a slowly growing lesion on the side of his temple. It is pearly colored and smooth. It is non ulcerative and non-tender, but has been changing in shape and he is concerned because his father and aunt both have a history of recurrent skin cancer. PSHx is significant for three oral surgeries for "cysts in his jaw", with no reactions to anesthesia. Excisional biopsy is performed resulting in the following:What other findings/problems is this patient at increased risk for having (select 3)?
- A.
  
  Early onset chronic obstructive pulmonary disease
- B.
  
  Cataract formation
- C.
  
  Calcification of the falx cerebri
- D.
  
  Palmar and plantar pitting
- E.
  
  Meduloblastoma
11.

A 15yo F presents with Right Maxillary Swelling. The key findings associated with this disease include all of the following EXCEPT:
- A.
  
  A wide range of recurrence from 5-60% depending on the surgical technique.
- B.
  
  The preferred treatement is surgical enucleation and osseous curettage, removing the specimen in one piece.
- C.
  
  Histologically distinct, this speicimen displays the characterisitc parakaeratinazation, with the flat epithelial-connective tissue interface resulting in a separation of the epithelium on processing.
- D.
  
  When multiple lesions of this nature appear, one should consider the diagnosis of McCune-Albright Syndrome.
- E.
  
  The lesions grow in a multilocular bosselated fashion with daughter cysts that extend into the surrounding bone. Because of this relationship, the tendency for recurrence is high, particularly if the original surgical treatment does not result in complete removal of the lesion.