prelegere tumori facial rom

Upload: viorelvelenciuc

Post on 21-Feb-2018

234 views

Category:

Documents


0 download

TRANSCRIPT

  • 7/24/2019 Prelegere Tumori Facial ROM

    1/54

    Tumorile masivuluiTumorile masivului

    facialfacial

  • 7/24/2019 Prelegere Tumori Facial ROM

    2/54

    Tumorile benigneTumorile benigne

    OdontogeneOdontogeneAmeloblastomAmeloblastom OdontomOdontom

    CementomCementom DentinomDentinom

    NeodontogeneNeodontogene OsteomOsteom Fibrom osifantFibrom osifant

    Displazia fbroasaDisplazia fbroasa ExostozeleExostozele Fibrom desmoidFibrom desmoid

    Condrom benignCondrom benign Fibrom condro-Fibrom condro-mixoidmixoid

  • 7/24/2019 Prelegere Tumori Facial ROM

    3/54

    PseudotumoriPseudotumoriGranulomul central de reparareGranulomul central de reparare

    Tumor[ cu mieloplaxeTumor[ cu mieloplaxeMixomulMixomulNeurinomulNeurinomul

    angiomulangiomul

  • 7/24/2019 Prelegere Tumori Facial ROM

    4/54

    Tumorile maligneTumorile maligne

    OdontogeneOdontogene CarcinomulCarcinomul

    odontogenodontogen SarcoameleSarcoamele

    ameloblasticeameloblastice

    NeodontogeneNeodontogene EpiteliomEpiteliom SarcomSarcom Melanom malignMelanom malign Neurom malign etc.Neurom malign etc.

    SecundareSecundaremetasta!e"metasta!e"

  • 7/24/2019 Prelegere Tumori Facial ROM

    5/54

    #meloblastoamele#meloblastoamele Este o afecEste o afec$iune a adultului$iune a adultului

    t%n&rt%n&r #re o evolu$ie progresivre o evolu$ie progresiv& 'ormat& din elimente'ormat& din elimente

    epiteliale ameloblasteepiteliale ameloblaste

    (ocali!area cea mai(ocali!area cea maifrecvent& ) mandibula*frecvent& ) mandibula*poate refula canalul dentarpoate refula canalul dentarinferior* deformea!&inferior* deformea!&corticalele. +mpinge*corticalele. +mpinge*de!organi!ea!& din$ii ,ide!organi!ea!& din$ii ,iproduce ri!ali!&.produce ri!ali!&.

    Poate - cistic& uni/ sauPoate - cistic& uni/ saumultilocular&" saumultilocular&" saucompact&.compact&.

    0ecidivea!& ,i poate s&0ecidivea!& ,i poate s&maligni!e!e.maligni!e!e.

  • 7/24/2019 Prelegere Tumori Facial ROM

    6/54

    'orma multilocular&'orma multilocular&

    (acune rotunde*(acune rotunde*inegale ca dimensiuni*inegale ca dimensiuni*bine individuali!atebine individuali!ate

    #re aspect de 1bule de#re aspect de 1bule de

    s&pun2s&pun2 3in regiunea3in regiunea

    gonionului* le!iunea segonionului* le!iunea se4ntinde ,i pe ramul4ntinde ,i pe ramul

    ascendent alascendent almandibulei* darmandibulei* darrespect& condilulrespect& condilulmandibular.mandibular.

    #fectare bilateral&*fractur& patologic&

  • 7/24/2019 Prelegere Tumori Facial ROM

    7/54

    'orma unilocular&'orma unilocular&

    Nu esteNu estecaracteristic&caracteristic&

    3iagnosticul3iagnosticuldiferen$iat5 cistuldiferen$iat5 cistulradiculo/dentar sauradiculo/dentar saucistul corono/dentarcistul corono/dentar

    3eformea!& t&blia3eformea!& t&bliaintern& dinintern& din

    vecin&tate* ceea cevecin&tate* ceea cenu se 4nt%mpl& 4nnu se 4nt%mpl& 4nca!ul unui cist.ca!ul unui cist.

  • 7/24/2019 Prelegere Tumori Facial ROM

    8/54

    OdontomaOdontoma

    3ependent& de foliculul3ependent& de folicululunui dinte care lipse,teunui dinte care lipse,tede pe arcad&" sau dede pe arcad&" sau defoliculi supranumerari*foliculi supranumerari*c%nd unul sau mai mul$ic%nd unul sau mai mul$i

    din$i sunt re$inu$i saudin$i sunt re$inu$i sauinclu,i.inclu,i. 'recvent la copii'recvent la copii 0ar la adul$i )0ar la adul$i )

    tumefac$ie dur& caretumefac$ie dur& care

    face corp comun cu osulface corp comun cu osul,i care are o evolu$ie,i care are o evolu$ielent&.lent&.

    'ormat& din $esuturi'ormat& din $esuturidentaredentare

  • 7/24/2019 Prelegere Tumori Facial ROM

    9/54

    #spectele radiologice#spectele radiologice

    Odontom compusOdontom compus Odontom complexOdontom complex

    Odontom mixtOdontom mixt

  • 7/24/2019 Prelegere Tumori Facial ROM

    10/54

    Odontom compusOdontom compus

    o mas& opac& format& din din$i 4no mas& opac& format& din din$i 4nminiatiur&* mai mult sau mai pu$inminiatiur&* mai mult sau mai pu$indismor-ci* frecvent observat& 4n regiuneadismor-ci* frecvent observat& 4n regiunea

    incisivilor.incisivilor.

  • 7/24/2019 Prelegere Tumori Facial ROM

    11/54

    Odontom complexOdontom complex

    Odontom complex )Odontom complex )mai pu$in frecvent*mai pu$in frecvent*repre!entat de orepre!entat de o

    forma$iune opac&forma$iune opac&grosier&* neregulat&*grosier&* neregulat&*cu contur muriform*cu contur muriform*situat& deseori 4nsituat& deseori 4n

    regiunea din$ilorregiunea din$ilorfrontali.frontali.

  • 7/24/2019 Prelegere Tumori Facial ROM

    12/54

    Odontom mixtOdontom mixt

    repre!entat derepre!entat deasocierea celorasocierea celordou& aspectedou& aspecte

    radiogra-ceradiogra-ceanterioareanterioare

  • 7/24/2019 Prelegere Tumori Facial ROM

    13/54

    Cementomul displa!ieCementomul displa!iecementar& periapical&"cementar& periapical&"

    3escoperit3escoperit4nt%mpl&tor la nivelul4nt%mpl&tor la nivelulmandibulei* 4nmandibulei* 4nvecin&tateavecin&tateaapexurilor r&d&cinelorapexurilor r&d&cinelorunuia sau ale maiunuia sau ale maimultor din$i evolua$imultor din$i evolua$i

    Cu timpul deformea!&Cu timpul deformea!&segmentul de os dinsegmentul de os dinvecin&tatevecin&tate

  • 7/24/2019 Prelegere Tumori Facial ROM

    14/54

    #specte radiologice#specte radiologice (acun& periapical&*(acun& periapical&*

    care ulterior devine ocare ulterior devine oopacitateopacitatecircumscris&* 4ncircumscris&* 4ncontact cu r&d&cinacontact cu r&d&cina

    unui dinte permanent.unui dinte permanent. Trabecula$ie radiar&*Trabecula$ie radiar&*

    pornind de la apex*pornind de la apex*traversea!& un spa$iutraversea!& un spa$iutransparent care otransparent care osepar& de osulsepar& de osuls&n&tos.s&n&tos.

    Sub$ia!& corticalaSub$ia!& corticalaosoas&* reali!%nd oosoas&* reali!%nd ococie periferic&.cocie periferic&.

  • 7/24/2019 Prelegere Tumori Facial ROM

    15/54

    3iagnosticul diferen$iat3iagnosticul diferen$iat

    'ibromul'ibromulcementi-antcementi-ant

    'ibromul osi-ant'ibromul osi-ant 11cementomcementom

    benign2benign2

    'ibromul cemi-ant )'ibromul cemi-ant )

    opacitate mai pu$inopacitate mai pu$inintens&intens&

    cementom

  • 7/24/2019 Prelegere Tumori Facial ROM

    16/54

    #lte tumori benigne#lte tumori benigneodontogeneodontogene

    'ibrom

    ameloblastic

    Mixom odontogen

    / 'ibroodontom

    / Odontom ameloblastic ) o tumor& rar&* repre!entat& dede!voltarea simultan& a unui ameloblastom ,i a unui odontomcomplex. Se de!volt& la nivelul maxilarului superior* la copii ,i laadultul t%n&r. 6maginea este asem&n&toare cu ce a unuiodontom complex.

  • 7/24/2019 Prelegere Tumori Facial ROM

    17/54

    CementoblastomaCementoblastoma

  • 7/24/2019 Prelegere Tumori Facial ROM

    18/54

    Tumori neodontogeneTumori neodontogenebenignebenigne

    'ibroblastice -brom osi-ant* displa!ie'ibroblastice -brom osi-ant* displa!ie-broas&* -brom desmoid"-broas&* -brom desmoid"

    Osteoformatoare osteom* osteom osteoid"Osteoformatoare osteom* osteom osteoid"

    Cartilaginoase exosto!a osteogenic&*Cartilaginoase exosto!a osteogenic&*condrom* condroblastom benign"condrom* condroblastom benign" Neoforma$iuni tumorale ,i pseudotumoraleNeoforma$iuni tumorale ,i pseudotumorale

    granulom central de reparare* tumor& cugranulom central de reparare* tumor& cu

    mieloplaxe* mixomul* neuronom* angiom*mieloplaxe* mixomul* neuronom* angiom*granulom eo!ino-l* cist anevrismal*granulom eo!ino-l* cist anevrismal*plasmocitom etc"plasmocitom etc"

  • 7/24/2019 Prelegere Tumori Facial ROM

    19/54

    reparare cu celulereparare cu celule

    giganticegigantice O le!iune neopla!ic&*O le!iune neopla!ic&*in7amatorie* intraosoas&*in7amatorie* intraosoas&*con$in%nd un $esut cu celulecon$in%nd un $esut cu celulegigante de natur& in7amatorie.gigante de natur& in7amatorie.

    (a tineri(a tineri +n regiunea sim-!ar&+n regiunea sim-!ar& 6maginea ) o lacun& bine6maginea ) o lacun& bine

    delimitat&* unic& saudelimitat&* unic& saupolilobat&* care su7& corticalapolilobat&* care su7& corticala,a care deplasea!& din$ii.,a care deplasea!& din$ii.

    Poate produce re!ali!&Poate produce re!ali!&

  • 7/24/2019 Prelegere Tumori Facial ROM

    20/54

    Osteomacentral&

    Granulom eo!ino-lGranulom eo!ino-l

    Osteoma

    periferic&Osteomuleste o opacitate osoas&.Maifrecvent situat& central dec%tperiferic. (ocali!at 4n regiunea condiluluimandibular* determin& latero/devia$iamandibulei c&tre partea s&n&toas& 4n

    momentul desciderii gurii"

  • 7/24/2019 Prelegere Tumori Facial ROM

    21/54

    'ibrom desmoid 'ibrom osi-ant'ibrom osi-ant

    3ispla!ia -broas&

    'ibromul osi-ant )pre!en$a unor travee-broaseosteoformatoare a unuios normal

    3ispa!ia -broas& )radiotransparen$&intraosoas&* limitat&* pe

    suprafa$a sa are -neo acit& i.

  • 7/24/2019 Prelegere Tumori Facial ROM

    22/54

    Osteocondrom

    Osteoma osteoid&

    Osteomul osteoideste o varietate deosteom* -indrepre!entat& de o

    opacitate scleroas&condensat&* careare central o !on&clar& nidus".Osteomul osteoideste foarte dureros

    ,i tratamentul estecirurgical.

  • 7/24/2019 Prelegere Tumori Facial ROM

    23/54

    Exoste!eleExoste!eleosteogeniceosteogenice

    Sesile sau pediculateSesile sau pediculate 3ependente de un3ependente de un

    segment osos normal*segment osos normal*continu%nd corticalacontinu%nd corticala

    'recvent 4n por$iunea'recvent 4n por$iuneavestibular& a regiuniivestibular& a regiuniimolare ,i pe fa$amolare ,i pe fa$aintern& a marginiiintern& a marginiibe!ilare a mandibulei.be!ilare a mandibulei.

  • 7/24/2019 Prelegere Tumori Facial ROM

    24/54

    3isp!ia -broas&3isp!ia -broas&

  • 7/24/2019 Prelegere Tumori Facial ROM

    25/54

    Clasi-carea cisturilorClasi-carea cisturilor

    Odontogene / radicular* periodontal*Odontogene / radicular* periodontal*folicular* re!idualfolicular* re!idual

    Neodontogene / na!opalatin* medialNeodontogene / na!opalatin* medial-sural* lateral -sural* medial-sural* lateral -sural* medialmandibular* re!idualmandibular* re!idual

    Pseudocisturi / solitar* anevrismal*Pseudocisturi / solitar* anevrismal*cavitate latent&cavitate latent&

  • 7/24/2019 Prelegere Tumori Facial ROM

    26/54

    Cist radicularCist radicular

  • 7/24/2019 Prelegere Tumori Facial ROM

    27/54

    Cist radicularCist radicular

  • 7/24/2019 Prelegere Tumori Facial ROM

    28/54

    Cist radicularCist radicular

  • 7/24/2019 Prelegere Tumori Facial ROM

    29/54

    Cist radicular re!idualCist radicular re!idual

  • 7/24/2019 Prelegere Tumori Facial ROM

    30/54

    Cist radicular re!idualCist radicular re!idual

  • 7/24/2019 Prelegere Tumori Facial ROM

    31/54

    CeratocistCeratocist

  • 7/24/2019 Prelegere Tumori Facial ROM

    32/54

    Cist folicularCist folicular

  • 7/24/2019 Prelegere Tumori Facial ROM

    33/54

    Cisturi neodontogeneCisturi neodontogene

  • 7/24/2019 Prelegere Tumori Facial ROM

    34/54

    Cist solitarCist solitar

  • 7/24/2019 Prelegere Tumori Facial ROM

    35/54

    #meloblastom#meloblastom

    http://scw.asahi-u.ac.jp/~kawamata/jpg/amelo2.jpg
  • 7/24/2019 Prelegere Tumori Facial ROM

    36/54

    #meloblastom#meloblastom

    http://scw.asahi-u.ac.jp/~kawamata/jpg/amelo2.jpghttp://scw.asahi-u.ac.jp/~kawamata/jpg/amelo2.jpghttp://scw.asahi-u.ac.jp/~kawamata/jpg/amelo2.jpg
  • 7/24/2019 Prelegere Tumori Facial ROM

    37/54

    Tumoare odontogen&Tumoare odontogen&adenomatoid&adenomatoid&

  • 7/24/2019 Prelegere Tumori Facial ROM

    38/54

    Cist calci-at odontogenCist calci-at odontogen

  • 7/24/2019 Prelegere Tumori Facial ROM

    39/54

    OdontomOdontom

    http://scw.asahi-u.ac.jp/~kawamata/jpg/odont1.jpghttp://scw.asahi-u.ac.jp/~kawamata/jpg/odont1.jpghttp://scw.asahi-u.ac.jp/~kawamata/jpg/odont1.jpg
  • 7/24/2019 Prelegere Tumori Facial ROM

    40/54

    OdontomOdontom

    http://scw.asahi-u.ac.jp/~kawamata/jpg/odont2.jpghttp://scw.asahi-u.ac.jp/~kawamata/jpg/odont2.jpghttp://scw.asahi-u.ac.jp/~kawamata/jpg/odont2.jpg
  • 7/24/2019 Prelegere Tumori Facial ROM

    41/54

    cementoblastom benigncementoblastom benign

  • 7/24/2019 Prelegere Tumori Facial ROM

    42/54

    radiotransparen$& format& din mairadiotransparen$& format& din maimulte cavit&$i reali!at& de septurimulte cavit&$i reali!at& de septuri

    netenete

  • 7/24/2019 Prelegere Tumori Facial ROM

    43/54

  • 7/24/2019 Prelegere Tumori Facial ROM

    44/54

  • 7/24/2019 Prelegere Tumori Facial ROM

    45/54

  • 7/24/2019 Prelegere Tumori Facial ROM

    46/54

  • 7/24/2019 Prelegere Tumori Facial ROM

    47/54

  • 7/24/2019 Prelegere Tumori Facial ROM

    48/54

    Semnele malignit&$iiSemnele malignit&$ii

  • 7/24/2019 Prelegere Tumori Facial ROM

    49/54

  • 7/24/2019 Prelegere Tumori Facial ROM

    50/54

    CarcinomCarcinom

    http://scw.asahi-u.ac.jp/~kawamata/jpg/okk1.jpghttp://scw.asahi-u.ac.jp/~kawamata/jpg/okk1.jpghttp://scw.asahi-u.ac.jp/~kawamata/jpg/okk1.jpg
  • 7/24/2019 Prelegere Tumori Facial ROM

    51/54

    CarcinomCarcinom

    http://scw.asahi-u.ac.jp/~kawamata/jpg/okk2.jpghttp://scw.asahi-u.ac.jp/~kawamata/jpg/okk2.jpghttp://scw.asahi-u.ac.jp/~kawamata/jpg/okk2.jpg
  • 7/24/2019 Prelegere Tumori Facial ROM

    52/54

    Sarcom osteogenSarcom osteogen

  • 7/24/2019 Prelegere Tumori Facial ROM

    53/54

    (ipom(ipom

    http://scw.asahi-u.ac.jp/~kawamata/jpg/lip1.jpghttp://scw.asahi-u.ac.jp/~kawamata/jpg/lip1.jpghttp://scw.asahi-u.ac.jp/~kawamata/jpg/lip1.jpg
  • 7/24/2019 Prelegere Tumori Facial ROM

    54/54