SARCOMA & DENTISTRY

1. Fibrosarcoma
C/F-Fleshy mass with ulceration in the
soft tissue area
R/F-Saucer shaped erosion of bone
H/F-Proliferation of fibroblasts &
formation of collagen & reticular
fibres. Mitotic figures are prominent
in small group of poorly differentiated
tumors
Liposarcoma
C/F-Soft, yellow colour slow silent growth
producing firm,resilient lesions sometimes
lobulated mostly on the cheek followed by
tongue.
H/F-Consists of fat cells & lipoblast in
varying degrees of differentiation &
anaplasia with variable stromal component
Osteosarcoma
C/F-Rapidly growing swelling of bone which
is accompanied by pain & discomfort
R/F-PDL space widening,sunray appearance
Codman’s triangle.
H/F-Serum alkaline phosphatase level is
increasedNeoplastic osteoblasts are spindle
shaped or polyhedral.Ewing’s Sarcoma
C/F-Intermittent pain in the bone
with rapidly growing swelling
R/F-Onion skin appearance
H/F-Cellular neoplasm composed
of solid sheets or masses of small
round cells with very little
stroma,although few connective
tissue septa can be seen
Multiple Myeloma
C/F-Skeletal pain with oral amyloidosis with
bleeding tendency
R/F- Punched out lesion in the skull
H/F-Chromatin clumping in ‘cartwheel’ or
checkerboard pattern
Bence Jones protein in urine
Non-Hodgkin’s Lymphoma
C/F-Bluish color mass of the palate with
multiple lymphnode involvement
R/F-Expansion of bone with radiolucency
L/F-Bloodcount shows hypersplenism or
hemolytic anemia.Reduced WBC & RBC
count with reduced hemoglobin level
Kaposi’s Sarcoma
C/F-Patch stage:pink,red or purple
macule;plaque
stage:Large,raised,violaceous
plaque;Nodular stage:Multiple
nodular lesion
H/F-Dilated,jagged,vascular
channels lined by spindle-type cells
Leukemia
C/F-Petechiae,ecchymosis,ulceration on
oral mucous membrane.Gingival hyper-
Trophy, lymph nodes may be enlarged.
L/F-WBC level increased.Hypercellular
bone marrow with replacement of
normal marrow elements by leukemic
blast cells in varying degree. Peripheral
blood smear shows mild anemia & large
number of small lymphocytes.
Hodgkin’s Lymphoma
C/F-Discrete enlargement of lymph nodes
rubbery in consistency with some systemic
signs
R/F-Foci of radiolucency in jaw
H/F-Reed-Sternberg cells are present;
Replacement of normal lymphnode by
admixture of malignant lymphoid cells
L/F- Normocytic normochromic anemia and
raised ESR
Chondrosarcoma
Malignant Fibrous Histiocytoma
Rhabdomyosarcoma
Angiosarcoma
Leiomyosarcoma
Neurofibrosarcoma
C/F-Rare in orall cavity.Lesion
appears as painful swelling.Secondery
ulceration of mucosal surface.
H/F-Neoplastic proliferation of
spindle-shaped malignant smooth
muscle cells in fascicles.
C/F-Rapidly growing soft tissue mass with
polypoid fleshy growth
H/F-Alveolar:Epithelial cells appear to be
‘Dropping off’ from collagen.Embroyinic:
Small round cells with monotonus looking
hyperchromatic nuclei:Pleomorphic:
C/F-Swelling of jaw,facial asymmetry,pain,
Tenderness, paresthesia later stage.
R/F-Moth eaten radiolucent area with ill
defined border.multiple flecks of
radioopacities
H/F-Shows hyaline cartilage.Can be grade
I,II or III
C/F-Fast expanding ,exophytic,
ulcerated,fleshy.
Pain,hemorrhage,paresthesia of
surrounding structures
R/F-Large,multilocular radiolucent area
with severe expansion of cortical plates
H/F-Spindle cells arranged in cartwheel or
storiform pattern.
Differential Diagnosis of Sarcoma in oral cavity
C/F-Rapidly growing lesion that
tend to ulcerate.Margin ill-
defined,surface firm
R/F-Ill-defined destruction of bone
H/F-Irregular vascular channels
lioned by endothelial cells that are
often pleomorphic
C/F-Rapid growth,occurs on lip,palate
Gingiva,pain & paresthesia may be.
R/F-Diffuse radiolucent lesion
H/F-Plumps of spindle shaped cells
arranged in streams & cords with
random nuclei
4th Prof B.D.S