Benign Non-Odontogenic Tumors

An overview
Ossifying Fibroma

• Uncommon
• Benign
• Slow-growing lesion of the jaws
• usually asymptomatic
• most commonly occurs in the mandibular
premolar area
• expansion and thinning of the buccal and
lingual cortical plates
Ossifying Fibroma

• The most important radiographic feature

of the lesion is its well-circumscribed,
sharply defined border. The initial
radiolucent stage gradually progresses
to a mixed radiolucent-radiopaque lesion
as calcified material is deposited within
the tumor. Describe the mature
ossifying lesion. Treatment?
Fibrous Dysplasia

• This is a condition in
which normal bone is
replaced with
abnormal bone and
fibrous connective
tissue. Note the
alterations in the
bone density.
Fibrous Dysplasia

• Occurs within the mandible and maxilla.

• Maxilla more frequently
• Asymptomatic
• Slow, unilateral enlargement of the
involved bone, most commonly resulting
in buccal cortical plate expansion.
Fibrous Dysplasia

• Radiopaque with numerous bony

trabeculae imparting a “ground glass”
appearance.
• Important distinguishing feature -- poorly
defined radiographic and clinical
margins of the lesion.
Chondroma

• Benign tumors composed of mature

cartilage
• Etiology unknown
• Usually occur in skeletal sites other than
jaws but, obviously, can occur in jaws
• Irregular, radiolucent
• Surgical excision
Osteoma

• This is a benign
neoplasm that is
characterized by
proliferation of
compact and
cancellous bone.
Note the radiopacity
in this radiograph
mesial to #31.
Osteoma

• These lesions most often occur in

solitary fashion, except when associated
with Gardner’s Syndrome.
• Gardner’s syndrome is an inherited
condition. It is characterized by
intestinal polyposis, multiple osteomas,
fibromas of the skin, epidermal and
trichilemmal cysts, impacted and...
Gardner’s con’t

• …and supernumerary teeth, and

odontomas. The majority of patients
with Gardner’s will not exhibit the
complete spectrum of clinical disease
expression. The presence of osteomas
in the jaws and facial bones should
prompt and investigation for the
possibility of Gardner’s Syndrome.
Osteomas

• Present radiographically as dense, well-

circumscribed radiopacities and,
clinically -- asymptomatic, slow-growing,
bony, hard masses. Asymmetry may be
noted when lesions enlarge to sufficient
proportion.
• Surgical excision
Central Giant Cell Granuloma

• Uncommon, benign process that occurs

almost exclusively within the jawbones.
The tumor typically presents as a
solitary, radiolucent lesion of the
mandible(more often) or maxilla.Usually
involve the jaws anterior to the molar
teeth. Giant cells involved( ).
thus the name

• Painless expansion. Curettage.

Giant Cell Tumor

• True neoplasms that arise most

frequently in long bones, especially in
area of the knee joint. Rarely occur in
jaws but possible.
Hemangioma of Bone

• Uncommon intraosseous lesions

consisting of proliferation of blood
vessels. The central hemangioma
occurs more frequently in vertebrae and
the skull. The maxilla and
mandible(more than maxilla) are the
next most common sites of occurrence.
• Etiology unknown
Hemangioma of Bone
• Slow-growing, asymmetric expansion of
mandible or maxilla
• radiographically -- appears as “soap
bubbles”(buzz word)
• Needle aspiration, then biopsy.
• Treatment possibilities: surgery,
radiation, sclerosing agents, cryotherapy
-- based on size and location of lesion
Tori and Exostoses

• Mandibular tori -
benign hereditary
condition involving
exostosis of the bone
on the lingual aspect
of the mandibular
premolar area.
Tori and Exostoses

• Exostoses are
nodular projections
of dense compact
bone on the buccal
and labial aspects of
the maxilla or
mandible, or both.
Review Information

• Desmoplastic • New to text

Fibroma • Rare, uncommon
• Osteoblastoma • Read information
• Osteoid Osteoma carefully
• Coronoid
Hyperplasia
Langerhan’s Cell Disease
• Formerly known as Histiocytosis X and
idiopathic histiocytosis
• Range from solitary or multiple bone
lesions to disseminated visceral, skin,
and bone lesions.
• Buzz words from this section: Hands-
Schuller-Christian syndrome, Letterer-
Siwe disease.
Review

Table and Photos in this chapter

for further understanding.