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Introduction to Tumors of PNS​


Cysts, Granulomas And Tumors Of The Jaw, Sinus
  1. Dentigerous Cysts: A cyst which envelops the whole or part of (the crown of the unerupted permanent tooth.
  2. Dental cyst: Occurs in association with an already erupted tooth.
    1. Sino –Nasal Tumors:
      Predisposing Factors:
      1. For nasal tumors: NICKEL (Duration of exposure: 18-36 yrs)
      2. Predisposes to squamous cell carcinoma and anaplastic carcinoma
    2. Ethmoid:
    3. Wood
      1. Hard wood: Adeno carcinoma
      2. Soft wood:  Squamous cell carcinoma
    4. Others agents:            
      1. Hydrocarbon: Isopropyl oil, Mustard oil
      2. Radium dye workers: Soft tissue carcinoma
      3. Welding/ soldering
        1. Age at presentation: 5th decade
        2. Male: Female = 2:1
        3. Commonest benign sino-nasal tumor: Osteoma
        4. Benign tumor in order of frequency
        5. Osteoma > Hemangioma > Papilloma

Extra Edge . Inverted papilloma or Ringertz tumour arises from the lateral wall of nose. It is characterised by squamous or transitional cell epithelium with fibrovascular stroma. Inward growth of epithelium towards stroma lends the name of inverted papilloma to it. It is associated with squamous cell carcinoma in 10-15% of patients. It arises from lateral wall of the nose.

  1. Benign Tumors:                                                   
    1. Epithelial
      1. Papilloma                              
      2. ​Adenoma
    2. Non- Epithelial
      1. Osteoma                            
      2. Fibroma                            
      3. Chondroma                                    
      4. Hemangioma
      5. Neurofibroma                
      6. Lymphangioma                              
      7. Nasal glioma
  2. Intermediate Category:
    1. Inverted papilloma (Ringertz Tumor)     
    2. Ameloblastoma              
    3. Fibrous Dysplasia    
    4. Ossifying fibroma
    5. Giant cell tumor
      1. Papilloma;
        1. Site: Skin of the nasal vestibule and the anterior part of the septum
        2. Treatment: Cautery/ cryotherapy
      2. Osteoma:
        1. Commonest site: Mandible
        2. Commonest site in the upper jaw: fronto- ethmoidal area
        3. (Frontal > Ethmoid > maxillary -sinus)
        4. Features: Most are clinically silent
        5. If close to the ostium ; Can lead to formation of mucocele
  3. Ossifying Fibroma:
    1. Age group : 3rd – 4th decade                        
    2. Sex: Male = Female
    3. Sites: Mandible and maxilla
  4. Fibrous Dysplasia:
    1. Infants & childhood            
    2. Female > Male
    3. Maxilla
  5. Inverting Papilloma: (It Is a benign tumor with malignant potential)
    1. Age : 40-70 yrs
    2. Sex: Male > Female
    3. Site:
      1. Lateral nasal wall
      2. Middle turbinate/Ethmoids
        - Features; (M/E): Finger like epithelial inversion into the underlying stroma of the epithelium.
        1. Firm, bulky, vascular                                                      
        2. Usually unilateral
        3. Locally aggressive tumors                                             
        4. 3-24%: Squamous cell carcinoma
        5. Treatment: Complete excision




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