Deck 7: Neoplasia

Question 1

"Keratin pearls" are a characteristic feature of

A) squamous cell carcinoma.
B) basal cell carcinoma.
C) pleomorphic adenoma.
D) monomorphic adenoma.

Answer 1

squamous cell carcinoma.

Question 2

Squamous cell carcinoma of the oral epithelium usually metastasizes first to which site?

A) Spleen
B) Lungs
C) Liver
D) Lymph nodes

Answer 2

Lymph nodes

Question 3

Which statement about erythroplakia is true?

A) Most cases of erythroplakia occur on the buccal mucosa and vestibule.
B) Erythroplakia is more common than leukoplakia.
C) When examined microscopically, 90% of cases of erythroplakia demonstrate epithelial dysplasia or squamous cell carcinoma.
D) Erythroplakia is considered a less serious clinical finding than leukoplakia.

Answer 3

When examined microscopically, 90% of cases of erythroplakia demonstrate epithelial dysplasia or squamous cell carcinoma.

Question 4

Which statement about epithelial dysplasia is true?

A) It is considered a malignant condition.
B) Unlike squamous cell carcinoma, cellular changes in epithelial dysplasia may revert to normal if the stimulus, such as tobacco smoking, is removed.
C) It presents clinically as an erythematous lesion and not a white lesion (leukoplakia).
D) Lesions often arise on the hard and soft palate.

Question 5

Where do most cases of papilloma occur?

A) Hard palate
B) Buccal mucosa
C) Soft palate or tongue
D) Retromolar area

Question 6

As a general rule, a patient should be referred to an oral and maxillofacial surgeon or dermatologist to have a biopsy performed on any non healing ulcer of the skin or lips that has been present for more than

A) 24 hours.
B) 2 weeks.
C) 3 months.
D) 1 year.

Question 7

Which choice represents a characteristic of malignant tumors?

A) Encapsulated
B) Ability to spread to distant sites
C) Benign
D) Cells resemble normal cells

Question 8

Most cases of verrucous carcinoma occur in the _____ years old.

A) posterior lateral border of the tongue of women over 40
B) floor of the mouth of women over 70
C) vestibule and buccal mucosa of men over 55
D) bone of the mandible of men over 20

Question 9

A papilloma is a _____ tumor derived from _____ epithelium.

A) benign; salivary gland
B) malignant; squamous
C) benign; squamous
D) malignant; odontogenic

Question 10

Anaplastic means the tumor

A) is composed of cells that vary in size and shape.
B) has cells with darker nuclei than those of normal cells.
C) has cells that exhibit an increased nuclear-to-cytoplasmic ratio.
D) does not resemble the tissue from which it was derived.

Question 11

According to the TNM staging system for oral squamous carcinoma, T?, N?, M? would mean tumor _____ cm in diameter, _____ palpable nodes, and _____ metastasis.

A) less than 2; ipsilateral; no distant
B) 2 to 4; ipsilateral; no distant
C) 2 to 4; contralateral; no distant
D) 2 to 4; contralateral; distant

Question 12

Idiopathic leukoplakia

A) is a malignant lesion of the oral mucosa.
B) can be rubbed off with gauze squares.
C) is caused by direct irritation, as in tobacco pouch keratosis.
D) does not have a specific known cause.

Question 13

Which choice is not regarded as an initiating factor in the development of oral cancer?

A) Cigar, pipe, and cigarette smoking
B) Snuff dipping and tobacco chewing
C) Consumption of alcohol
D) Chronic irritation

Question 14

Verrucous carcinoma

A) has a better prognosis than other forms of squamous cell carcinomas.
B) appears clinically as a quick-growing exophytic tumor with a pebbly white surface.
C) is characterized by poorly differentiated epithelium with atypical cells.
D) shows invasion of tumor cells through the basement membrane.

Question 15

An intraoral mucosal lesion that shows a mixture of red and white areas is termed

A) erythroplakia.
B) speckled erythroplakia.
C) speckled leukoplakia.
D) leukoplakia.

Question 16

Basal cell carcinoma is a _____ tumor that _____ in the oral cavity.

A) benign; occurs
B) malignant; occurs
C) benign; does not occur
D) malignant; does not occur

Question 17

Squamous cell carcinomas on the vermilion border of the lips and skin of the face are

A) associated with lack of exposure to the sun and vitamin D deficiency.
B) more common in individuals with dark skin.
C) associated with a poorer prognosis than that for squamous cell carcinoma of the oral mucosa.
D) associated with color changes of the vermilion border from dark pink and uniform to mottled grayish pink.

Question 18

A benign tumor of bone is called a(n)

A) osteoma.
B) osteogenic sarcoma.
C) chondroma.
D) carcinoma.

Question 19

Severe epithelial dysplasia involving the full thickness of the epithelium is termed

A) anaplasia.
B) squamous cell carcinoma.
C) carcinoma in situ.
D) metastasis.

Question 20

Intraoral minor salivary gland tumors are most commonly located

A) on the labial and buccal mucosa.
B) at the junction of the hard and soft palate.
C) on the retromolar area.
D) on the floor of the mouth.

Question 21

Which tumor most closely resembles an ameloblastoma with ameloblast-like epithelial cells surrounding areas that look like stellate reticulum?

A) Calcifying epithelial odontogenic tumor
B) Adenomatoid odontogenic tumor
C) Calcifying odontogenic cyst
D) Odontogenic myxoma

Question 22

Ghost cells are characteristic of which lesion?

A) Calcifying odontogenic cyst
B) Adenomatoid odontogenic tumor
C) Calcifying epithelial odontogenic tumor
D) Ameloblastoma

Question 23

How does an adenomatoid odontogenic tumor differ from a dentigerous cyst on radiographic images?

A) It will not be associated with an impacted tooth.
B) It extends beyond the cementoenamel junction and can involve 50% to 60% of the root.
C) It will not form calcifications within the tumor, as does a dentigerous cyst.
D) It will not form a well-circumscribed radiolucency.

Question 24

Most ameloblastomas are located in the

A) anterior maxilla.
B) posterior maxilla.
C) anterior mandible.
D) posterior mandible.

Question 25

Which is the most common malignant salivary gland tumor found in children?

A) Adenoid cystic carcinoma
B) Mucoepidermoid carcinoma
C) Monomorphic adenoma
D) Pleomorphic adenoma

Question 26

The most common intraoral location for the pleomorphic adenoma is the

A) parotid gland.
B) submandibular gland.
C) palate.
D) floor of the mouth.

Question 27

Which tumor occurs most frequently in the anterior part of the jaws?

A) Ameloblastoma
B) Calcifying epithelial odontogenic tumor
C) Adenomatoid odontogenic tumor
D) Odontogenic myxoma

Question 28

Which is the most common salivary gland neoplasm?

A) Adenoid cystic carcinoma
B) Mucoepidermoid carcinoma
C) Pleomorphic adenoma
D) Monomorphic adenoma

Question 29

The pleomorphic adenoma

A) is a malignant tumor.
B) appears clinically as a painful dome-shaped mass.
C) occurs most often in children.
D) appears as a slowly enlarging, nonulcerated, painless, dome-shaped mass.

Question 30

The ameloblastic fibroma

A) occurs most often in adults over 50.
B) occurs more commonly in males than females.
C) is most commonly located in the mandibular anterior region.
D) is most commonly located in the maxillary anterior region.

Question 31

Which salivary gland tumor has a "Swiss cheese" appearance under the microscope?

A) Pleomorphic adenoma
B) Monomorphic adenoma
C) Adenoid cystic carcinoma
D) Mucoepidermoid carcinoma

Question 32

Which tumor is an unencapsulated, infiltrating tumor composed of a combination of mucous cells interspersed with squamous-like epithelial cells?

A) Adenoid cystic carcinoma
B) Mucoepidermoid carcinoma
C) Monomorphic adenoma
D) Pleomorphic adenoma

Question 33

A benign tumor of salivary gland origin is termed a(n)

A) leiomyoma.
B) lipoma.
C) adenoma.
D) papilloma.

Question 34

The ameloblastoma

A) occurs exclusively in the mandible.
B) is a benign, encapsulated tumor.
C) is commonly known as a Pindborg tumor.
D) may cause expansion of bone.

Question 35

The adenoid cystic carcinoma is

A) a benign tumor of salivary gland origin.
B) well encapsulated and does not infiltrate surrounding tissue.
C) most commonly seen intraorally on the palate.
D) painless.

Question 36

The adenomatoid odontogenic tumor features ductlike structures that

A) resemble those found in major salivary glands.
B) resemble those found in minor salivary glands.
C) are actually ameloblast-like cells that resemble ducts because of their circular arrangement.
D) are actually odontoblast-like cells that resemble ducts because of their circular arrangement.

Question 37

The Warthin tumor

A) is a unique type of pleomorphic adenoma.
B) presents as a painless, soft mass, usually in the sublingual gland.
C) often develops bilaterally in adult women.
D) contains sheets of lymphocytes that surround the cystic structures.

Question 38

Adenoid cystic carcinoma is commonly seen in which demographic group?

A) Men
B) Women of childbearing age
C) Fifth and sixth decades of life
D) Children

Question 39

Which statement is true of the odontogenic myxoma?

A) It occurs most often in people over 50.
B) It exhibits a unilocular radiolucency with well-defined margins.
C) The tumor may become quite large and cause displacement of teeth.
D) Most cases arise in the posterior maxilla.

Question 40

A central mucoepidermoid carcinoma is derived from either salivary gland tissue trapped within bone or

A) a periapical abscess surrounding the apex of a nonvital tooth.
B) the transformed epithelial lining of a dentigerous cyst.
C) a lateral periodontal cyst.
D) an incisive canal cyst.

Question 41

Bence Jones proteins are associated with

A) osteosarcoma.
B) leukemia.
C) lymphoma.
D) multiple myeloma.

Question 42

A rhabdomyosarcoma is a _____ tumor of _____ muscle.

A) benign; smooth
B) malignant; smooth
C) benign; striated
D) malignant; striated

Question 43

A lipoma

A) is a tumor of peripheral nerve tissue.
B) appears clinically as a yellowish mass surfaced by a thin layer of epithelium.
C) is found most commonly intraorally on the tongue.
D) occurs most often in men over 60.

Question 44

The central cemento ossifying fibroma is most likely derived from which cells?

A) Ameloblasts
B) Odontoblasts
C) Osteoblasts
D) Cells of the periodontal ligament

Question 45

Which is a common characteristic of benign neoplasms?

A) Inability to spread to distant sites
B) Nonencapsulated
C) Undifferentiated and pleomorphic
D) No resemblance to surrounding cells

Question 46

The benign oral pathologic lesion that occurs frequently in the head and neck area and is classified as capillary or cavernous is termed

A) hematoma.
B) lipoma.
C) adenoma.
D) hemangioma.

Question 47

All are common warning signs of malignant neoplasms except one. Which is the exception?

A) Leukoplakia
B) Bleeding
C) Erythroplakia
D) Pigmentation

Question 48

Which statement about hemangiomas is true?

A) The gingiva is the most common intraoral location.
B) They are more common in boys than in girls.
C) They appear as variably sized, deep red or blue lesions that do not blanch when pressure is applied.
D) They may occur in adults as a response to trauma and represent an abnormal proliferation of blood vessels during the healing process.

Question 49

Where is the most frequent intraoral site for metastatic tumors of the jaws?

A) Nares
B) Maxilla
C) Mandible
D) Zygoma

Question 50

A compound odontoma

A) consists of a mass of enamel, dentin, cementum, and pulp that does not resemble a normal tooth.
B) usually occurs in the posterior mandible.
C) appears on radiographs as a cluster of miniature teeth surrounded by a radiolucent halo.
D) appears as a radiolucent mass surrounded by a thin radiopaque halo.

Question 51

The granular cell tumor

A) most often occurs on the tongue followed by the buccal mucosa.
B) appears as a painful, ulcerated nodule.
C) occurs most commonly in children.
D) occurs most often in men.

Question 52

The most common location for an intraoral lymphoma is the

A) floor of the mouth.
B) posterior lateral border of the tongue.
C) tonsillar area.
D) vestibule.

Question 53

Kaposi sarcoma is

A) caused by a human herpesvirus.
B) seen only in association with HIV infection.
C) most often seen intraorally on the tongue.
D) a malignant striated muscle tumor.

Question 54

A common location of the oral neurofibroma is the

A) tongue.
B) palate.
C) gingiva.
D) buccal mucosa.

Question 55

Acute leukemia is characterized by a proliferation of _____ cells.

A) immature white blood
B) mature white blood
C) immature plasma
D) mature plasma

Question 56

The most common intraoral location for a neurofibroma is the

A) floor of the mouth.
B) vestibule.
C) tongue.
D) tonsillar pillar.

Question 57

Which statement about malignant melanoma is true?

A) It has a benign counterpart known as the benign melanoma.
B) Most malignant melanomas arise on the skin as a result of prolonged exposure to chemicals such as benzene.
C) Primary malignant melanoma of the oral cavity is rare.
D) The most common intraoral location is the tongue.

Question 58

Multiple myeloma is a systemic, malignant proliferation of

A) red blood cells.
B) plasma cells.
C) eosinophils.
D) basophils.

Question 59

A "sunburst" pattern is associated with

A) Kaposi sarcoma.
B) osteoma.
C) osteosarcoma.
D) multiple myeloma.

Question 60

Malignant melanoma usually presents as a(n)

A) slowly enlarging white mass.
B) rapidly enlarging blue-to-black mass.
C) slowly enlarging papule.
D) exophytic, wartlike lesion.

Question 61

Squamous cell carcinoma of the oral epithelium usually metastasizes first to the lymph nodes of the neck. Common distant sites include

A) kidneys and spleen.
B) lungs and liver.
C) breast and lungs.
D) liver and spleen.

Question 62

The _____ is a unique type of monomorphic adenoma.

A) verrucous carcinoma
B) mucoepidermoid carcinoma
C) cylindroma
D) papillary cystadenoma lymphomatosum

Question 63

Epithelial dysplasia is a microscopy-based diagnosis; it indicates disordered growth and is considered a premalignant condition.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second is false.
D) The first statement is false; the second is true.

Question 64

A benign tumor of cartilage is termed a(n)

A) osteoma.
B) lipoma.
C) chondroma.
D) carcinoma.

Question 65

Patients who have undergone radiation therapy for malignant tumors of the head and neck often experience severe xerostomia as a result of radiation damage to _____ tissue.

A) oral mucosa
B) striated muscle
C) salivary gland
D) tooth

Question 66

The multiple myeloma is a benign proliferation of plasma cells that produce large amounts of immunoglobulin. Patients usually experience bone pain and swelling.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true; the second is false.
D) The first statement is false; the second is true.

Question 67

Approximately _____% of leukoplakias examined microscopically demonstrate epithelial dysplasia.

A) 1 to 2
B) 5 to 25
C) 50 to 60
D) 90

Question 68

This benign tumor of fat cells that clinically appears as a yellowish mass surfaced by a thin layer of epithelium is referred to as a

A) chondroma.
B) rhabdomyosarcoma.
C) lipoma.
D) lymphoma.

Question 69

An ameloblastoma may appear as a _____ on radiographic images.

A) unilocular radiolucency
B) multilocular opacity
C) unilocular or multilocular radiolucency
D) unilocular or multilocular radiopacity

Question 70

A _____ both invades and destroys surrounding tissue and has the ability to spread throughout the body.

A) benign tumor
B) malignant tumor
C) hypertrophy
D) hyperplasia

Question 71

When a mucoepidermoid carcinoma arises within bone, it will usually be found in the _____ region.

A) maxillary anterior
B) maxillary posterior
C) mandibular anterior
D) mandibular posterior

Question 72

The name of the benign tumor that is slow growing but locally aggressive and derived in association with an impacted tooth and dentigerous cyst is termed

A) calcifying odontogenic cyst.
B) odontogenic myxoma.
C) compound odontoma.
D) ameloblastoma.

Question 73

A benign cementoblastoma has all these radiographic characteristics except one. Which is the exception?

A) Well circumscribed
B) Radiopaque
C) Attached to root
D) Multilocular

Question 74

Sarcomas are _____ common than carcinomas.

A) 10 times more
B) 3 times more
C) 3 times less
D) 10 times less

Question 75

A basal cell carcinoma will _____ metastasize.

A) never
B) rarely
C) often
D) always

Question 76

The distinction between dangerous and innocuous leukoplakia is best determined by the

A) clinical appearance of the lesion.
B) identification of predisposing factors.
C) patient's previous experience.
D) biopsy of the lesion.

Question 77

According to the TNM staging system for oral squamous carcinoma, T?, N?, M? would mean tumor _____ cm in diameter, _____ palpable nodes, and _____ metastasis.

A) less than; ipsilateral; no distant
B) is 2 to 4; ipsilateral; no distant
C) greater than 4; no; no distant
D) greater than 4; contralateral; distant

Question 78

The diagnosis of oral osteosarcoma is dependent on

A) clinical examination.
B) palpation.
C) radiographic interpretation.
D) patient symptoms.

Question 79

_____ means new growth.

A) Metastasis
B) Neoplasia
C) Hypertrophy
D) Hyperplasia

Question 80

All carcinomas are malignant tumors that originate from squamous epithelium except one. Which is the exception?

A) Adenoid cystic
B) Basal cell
C) Verrucous
D) Squamous cell