WSI22-145: Oral Cavity

From MGH Learn Pathology


Request type Study
Subspecialty Head and Neck
Set ENT Pathology
Topic Oral Cavity
Presenter Sadow, Peter M.,MD, PhD
Date and time Saturday, October 1, 2022 12:00 PM


Toggle columns: Diagnosis

Case Clinical history Requester Diagnosis
Case Clinical history Requester Diagnosis

Case 1


10 year old male with radiolucent lesion in the 3rd molar area of the right mandible Si787 Ameloblastic fibro-odontoma

Case 2


56 year old male with right tonsil lesion Si787 Papillary SCC largely non-keratinizing likely invasive. + HPV16 +P16 -BCL2

Case 3


32 year old male with multiple lesion of oral cavity and oropharynx with large airway-obstructing mass on epiglottis Si787 Squamous papilloma with high grade dysplasia positive for HPV32 c/2 Heck's disease

Case 4


66 year old male with left neck mass; left tonsil biopsy Si787 Invasive squamous cell carcinoma non-keratinizing

Case 5


58 year old former smoker s/p laryngectomy in 2006. Right oral cavity lesion (this) 2011 and right tonsillar mass 2012. Si787 Non-keratinizing SCC HPV16+

Case 6


82 year old female with palate lesion Si787 Mucoepidermoid carcinoma low grade (1.5 cm)

Case 7


67 year old female with a base of tongue lesion Si787 Adenoid cystic carcinoma predominantly tubular type with focal perineural invasion

Case 8


27 year old male with tongue lesion Si787 Low grade round to fusiform cell lesion c/w ectomesenchymal chondromyxoid tumor of the anterior tongue

Case 9


48 year old female with left vocal cord lesion Si787 IgG4-related disease

Case 10


34 year old female with left mandible cyst Si787 Keratocystic odontogenic tumor (KCOT)

Case 11


15 year old male with right mandibular lesion Si787 Giant cell lesion involving bone and soft tissue

Case 12


13 year old female with left maxillary lesion Si787 Fibrous lesion

Case 13


24 year old female with left mandibular cystic lesion Si787 Ameloblastoma plexiform unicystic type

Case 14


8 year old female with right maxillary mass Si787 Compound odontoma (4.4 cm)

Case 15


19 year old male who noticed a lump on the left side of his jaw growing larger over the course of 2 months Si787 Ewing sarcoma (4.4 cm) infiltrating masseter madible and mandibular marrow. Margins negative. +EWSR1 rearrangement + CD99 + Fli1 + Synapto

Case 16


13 year old male with monostotic fibrous dysplasia Si787 Fibrous dysplasia

Case 17


7 year old female with undescended tooth question mass by xray Si787 Ameloblatoma involving maxilla

Case 18


65 year old male with left retromolar area lesion Si787 Hemangioma with overlying ulceration squamous hyperplasia and granulation tissue

Case 19


11 year old male with lesion around tooth #22 Si787 Ameloblastic fibromyxoma

Case 20


24 year old female with left mandibular cyst previously biopsied as c/w dentigenous cyst with persistent clinically cystic lesion Si787 Ameloblastoma plexiform type

Case 21


35 year old female with tumor of the maxilla impacted tooth bony lesion Si787 Cemento-osseous dysplasia

Case 22


39 year old female with pain and swelling s/p dx of fibro-osseous dysplasia Si787 Ameloblastoma desmoplastic type

Case 23


26 year old female with mixed radiolucent/radiopaque tumor of the left mandible and 3-4 month expansion of right jaw Si787 Cemento-ossifying fibroma (1.4 cm) with associated fibrous dysplasia. R - sided tumor. L - also fibrous dysplasia

Case 24


3 year old female with expansive mandibular mass Si787 Compound odontoma

Case 25


62 year old male with gingival lesion Si787 Submucosal proliferation of giant cells s/o a giant cell lesion (central reparative granules)

Case 26


Otherwise healthy 75 yo female with 3 week h/o swelling in her anterior maxillary region. Not painful tender Si787 Lateral periodontal cyst

Case 27


7 year old female with right maxillary swelling and lack of eruption of first molar Si787 Compound odontoma (4.4 cm)

Case 28


70 year old female with hard palate lesion adjacent to an incisor Si787 Neurofibroma

Case 29


81 year old female with gingiva lesion and no prior carcinoma but previous biopsy with atypia Si787 Well differentiated SCC keratinizing arising in association with keratinizing lichenoid dysplasia

Case 30


22 year old female with McCune-Albright syndrome and left mandible lesion Si787 Fibrous dysplasia

Case 31


64 year old male with base of tongue mass Si787 Plasmacytoma (1.9 cm)

Case 32


30 year old hospital employee who presents with recurrent disease post-maxillectomy in 2008 (4 yrs post excision). He first presented following noting a submucosal mass in the soft palate for 6 months for which his dentist referred him to an oral maxillofacial surgeon. Currently with recurrent disease in left mandible and left pterygopalatine fossa. This slide is from the 2008 maxillectomy. Si787 Adenoid cystic carcinoma cribriform and tubular types

Case 33


44 year old male with large expansile lesion of right mandible associated with impacted teeth; ? OKC vs dentigenous cyst. r/o ameloblastoma Si787 Ameloblastoma

Case 34


55 year old female with chronic otitis media Si787 Malleus superstructure

Case 35


59 year old female with h/o oral cancer pT4 treated by surgery & chemo rad now with new tongue mass Si787 Spindle cell squamous cell carcinoma

Case 36


74 year old female with maxillary sinus lesion Si787 Moderately differentiated SCC with extensive necrosis arising in a small component of primary Schneiderian papilloma inverted type.

Case 37


30 year old female with tongue mass Si787 Granular cell tumor

Case 38


51 year old male with cheek lesion Si787 Mucinous adenocarcinoma CK7 and CK19+. DDX: Salivary adnexal

Case 39


69 year old female presents with mass in right palate over course of 2 months noticed due to ill-fitting dentures Si787 Salivary duct carcinoma with Her 2 amplification and - mutation

Case 40


13 year old female with exophytic polypoid palate lesion Si787 Malignant spindle cell neoplasm most c/w melanoma

Case 41


70 years old female with recurrent lesion of the right maxilla Si787 Polymorphous adenocarcinoma with perineural invasion and infiltration of the maxilla

Case 42


47 year old woman with tongue les Si787 Epithelioid schwannoma

Case 43


64 years old male with gingival lesion Si787 Ameloblastoma extraosseous/peripheral type

Case 44


52 year old male Si787 Acute osteomyelitis with sulfur granules compatible with actinomyctes species involvement + 2 lymph nodes with subcapsular fibrosis

Case 45


25 year old male Si787 Behcet's disease. Ulceration dense neutrophilic infiltrate small vessel vasculitis (B)

Case 46


48 year old male Si787 Keratogenic odontogenic tumor (odontogenic keratocyst)

Case 47


1 year old male Si787 Langerhans histiocytosis

Case 48


30 year old male Si787 Chondroblastic osteosarcoma with giant cell rich areas grade 2-3 of 3

Case 49


65 year old female Si787 Intraosseous malignant neoplasm most c/w ameloblstic carcinoma

Case 50


78 year old male Si787 Acute osteomyelitis with focal involvement by Actinomyces species

Case 51


65 year old male Si787 Subepithelial amyloid

Case 52


38 year old female Si787 Chondroblastic osteosarcoma high grade (2.2) cm)

Case 53


58 year old female Si787 Low grade odontogenic cystic neoplasm with prominent squamous differentiation most c/w an ameloblastoma acantholytic type

Case 54


81 year old male Si787 Giant cell tumor of bone (3.3 cm) with polypoid extension into extramandibular soft tissue

Case 55


77-year-old man with clinical lichen planus of the tongue. Pms36 Biphenotypic carcinoma likely a composite/collision of invasive well-differentiated squamous cell carcinoma keratinizing and a biphasic salivary-type carcinoma seemingly basal cell adenocarcinoma with the salivary component extending to tissue edges.

Case 56


62-year-old woman who came to medical attention due to irritation of her palate. Pms36 Microsecretory adenocarcinoma of the palate (2.6 cm) invasive into maxilla with no evidence of lymphovascular or perineural invasion completely excised. Tumor cells are positive for p63 and negative for p40. Tumor cells are diffusely positive for S100 Sox10 keratin 7 MNF116 INI1 (SMARCB1 retained) BRG1 (SMARCA4 retained) PLAG1. Tumor cells are negative for GATA3 NR4A3 mammaglobin CD117 (ckit) MYB androgen receptor and HMGA2. FISH for SS18 is POSITIVE.

Case 57


75-year-old woman with a history of basal cell and squamous cell carcinomas of the right cheek left cheek and nasolabial fold. Now with left maxillary buccal mass (1.4 cm). Pms36 Canalicular adenoma (1.4 cm) received fragmented.

Case 58


65-year-old woman with arthroplasty of her right temporomandibular joint. She presented following a 5 year history of increasing right-sided TMJ following a tooth extraction. Chiropractor caused exacerbation of pain. Pms36 Nodular cartilaginous proliferation consistent with calcified chondroid mesenchymal neoplasm. Fusion assay confirms FN1::FGFR2 fusion in the tumor.