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 appearanceCodman’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 appearanceH/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 tendencyR/F- Punched out lesion in the skullH/F-Chromatin clumping in ‘cartwheel’ or checkerboard patternBence Jones protein in urine

Non-Hodgkin’s Lymphoma

C/F-Bluish color mass of the palate with multiple lymphnode involvementR/F-Expansion of bone with radiolucencyL/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 lesionH/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 signsR/F-Foci of radiolucency in jawH/F-Reed-Sternberg cells are present; Replacement of normal lymphnode by admixture of malignant lymphoid cellsL/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 growthH/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 radioopacitiesH/F-Shows hyaline cartilage.Can be grade I,II or III

C/F-Fast expanding ,exophytic, ulcerated,fleshy.Pain,hemorrhage,paresthesia of surrounding structuresR/F-Large,multilocular radiolucent area with severe expansion of cortical platesH/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 firmR/F-Ill-defined destruction of boneH/F-Irregular vascular channels lioned by endothelial cells that are often pleomorphic

C/F-Rapid growth,occurs on lip,palateGingiva,pain & paresthesia may be.R/F-Diffuse radiolucent lesionH/F-Plumps of spindle shaped cells arranged in streams & cords with random nuclei

4th Prof B.D.S