OSTEOMA Clinical Benign Features Slow growing tumour central/subperiosteal lesion > mandible Diagnosed in adult life D/D

e D/D : central osteoma from dense bone island subperiosteal osteoma from exostosis usually solitary multiple in Gardner syndrome : AD Polyposis coli:marked tendency for malignant change Multiple fibrous tumoure Epidermal/sebaceous cyst of skin Multiple impacted and supernumerary teeth Histopath Well differentiated mature bone ologic Compact (ivory) and cacellous Features type

OSTEOSARCOMA Commonest 1 malignant tumour of bone Relatively rare in jaws Central(intramedullary) / periosteum(juxcortical) juxcortical have better prognosis than intermedullary Jaw : Age of onset : 30years of age (occasionally in older patient) Swelling Pain, toothache Paraesthesia Bleeding Loose/displaced teeth Increased incidence in pagets disease mandibular lesion better prognosis

CHONDROSARCOMA chondrosarcoma and chondromarare tumours in jaw commonest site : ant part of maxilla post part of mandible > common than chondroma slower growth rate than other sarcomas > maxilla Prognosis : poorer than osteosarcoma mandibular better prognosis than maxilla

HAEMANGIOMA OF BONE rare lesion > mandible Aspiration : fresh blood

METASTATIC TUMOURS 1% oral cavity tumours Bone metastatasis > soft tisuue > mandible 1 tumour metastasis to jaw-carcinomas of breast, prostate, lung, bronchus, kidney Clinically Pain Lose of teeth Swelling Paraesthesia / anaesthesia of lip (inf dental nerve) Many are asymptomatic Osteolytic(mainly) and osteoblastic (breast and prostate)

Microscopic : malignant Microscopic : osteoblast + direct formation of Abnormal chondroblast and abnormal osteoid and bone cartilage High degree of cellularity and of plump , binucleate cells (well diff.) Difficult to distinguish from chondroma Chondroma : Formation of mature cartilage Calcification and endochondral ossification in benign and malignant tumour

Cavernous type

Radiograp Clearly circumscribed lesion hic

Radiolucent / radiopaque / mixed lesion Margins are poorly defined sun-ray appearance-bony trabeculae radiating from periphery/periosteum (present in 25% of cases and not unique to osteosarcoma) Early feature:localized symmetrical widening of periodontal ligament space

Radiolucent /radiopaque / mixed Poorly defined

Osteolytic defect multilocular radiolucency (honey-comb appearance )

radiopacity

Extra info Osteoblastoma : Treatment : Histologically and radiographically Radical surgery resembles cementoblastoma (but Radiation therapy it is not related to roots of Chemotherapy teeth) Adenoma + osteoma =Multiple Gardner Syndrom

Treatment : Radical surgery

Most common site for metastasis is gingival / alveolar mucosa followed by tongue

adenoma