Home/Quiz/Board Exams MCQs on Cysts and Tumors of Head and Neck – Oral and Maxillofacial Surgery Board Exams MCQs on Cysts and Tumors of Head and Neck – Oral and Maxillofacial Surgery Welcome to your Board Exams MCQs on Cysts and Tumors of Head and Neck - Oral and Maxillofacial Surgery 1. A large odontogenic cyst is closely related to the inferior alveolar nerve and adjacent teeth. The surgeon decides to perform marsupialization to reduce cyst size and preserve surrounding structures. Which of the following is NOT an advantage of marsupialization? Exposure of very little bone Preservation of vital structures Rapid healing Conserves surgical sutures Reduced risk of jaw fracture in large cysts None 2. A panoramic radiograph reveals a large radiolucent lesion within the mandible. Before performing a biopsy, the surgeon inserts a needle into the lesion to determine its contents and avoid catastrophic hemorrhage. Needle aspiration of a central bone lesion is primarily useful for: Ruling out a vascular lesion Determining thickness of the buccal plate Diagnosing a traumatic bone cyst Feeling root surfaces Determining tooth vitality None 3. A 35-year-old patient is diagnosed with a 3 cm ameloblastoma involving the inferior border of the mandible. Radiographic examination shows cortical involvement extending to the lower border of the jaw. Considering the locally aggressive nature and high recurrence rate of ameloblastoma, which surgical treatment is most appropriate? Enucleation Fulguration Cryosurgery Resection Marsupialization None 4. A radiolucent lesion of the posterior mandible is suspected to be an odontogenic keratocyst (OKC). Before biopsy, needle aspiration is performed. Which of the following findings is most characteristic of the aspirate from an odontogenic keratocyst? A low soluble protein content A high soluble protein content Cholesterol crystals Inflammatory cells Frank blood aspirate None 5. A 17-year-old patient presents with an incidental radiolucent lesion in the posterior mandible. During surgical exploration, the surgeon finds an empty bone cavity with little or no fluid and no epithelial lining. Histopathological examination confirms the absence of a true cystic lining. What is the most likely diagnosis? Aneurysmal bone cyst Idiopathic bone cavity Dentigerous cyst Keratocyst Radicular cyst None 6. A 14-year-old boy presents with delayed eruption of a mandibular second molar. Radiographic examination reveals a dentigerous cyst surrounding the crown of the unerupted tooth. Because of the patient's young age and the eruption potential of the tooth, what is the most appropriate treatment? Extraction of the molar Aspiration of the cyst Observation only Expose the crown and keep it exposed Segmental resection None 7. A patient is diagnosed with an odontogenic cyst of moderate size involving the posterior mandible. The surgeon plans definitive treatment to completely remove the cystic lining and minimize recurrence. Which of the following is the most commonly indicated surgical procedure for odontogenic cysts? Incision and drainage Sclerosing solution Marsupialization Enucleation Curettage only None 8. A surgeon treats a large odontogenic cyst by removing the roof of the cyst and suturing the surrounding oral mucosa/periosteum to the cyst lining, thereby creating a permanent opening into the oral cavity and reducing intracystic pressure. This procedure is known as: Decortication Marsupialization Saucerization Enucleation Curettage None 9. A 32-year-old patient is diagnosed with a conventional solid/multicystic ameloblastoma of the mandible. Histopathology confirms a benign but locally aggressive odontogenic tumor with a high recurrence rate if treated conservatively. What is the best management option? Chemotherapy Radiotherapy Gene Therapy Surgical excision Observation only None 10. A radiolucent lesion associated with the crown of an impacted mandibular third molar is suspected to be either a dentigerous cyst or a unicystic ameloblastoma. Since both lesions may appear similar clinically and radiographically, which of the following is the most reliable method to differentiate between them? Radiographic examination Aspiration cytology Microscopic examination Clinical features Pulp vitality testing None 11. A 16-year-old patient presents with a slowly enlarging, painless swelling of the maxilla. Radiographic examination shows a characteristic ground-glass appearance, and biopsy confirms fibrous dysplasia. What is the most appropriate treatment? Radical resection of the lesion Radiation therapy If the lesion is small, dissection is done. If the lesion is large, cosmetic surgery has to be carried out. Cryosurgery Chemotherapy None 12. A man presents with a 1 × 1.5 cm pedunculated lesion on the soft palate. The lesion has a rough, warty (papillary) surface and is the same color as the adjacent mucosa. The lesion appears clinically benign and is small enough to be removed completely. What is the most appropriate management? Perform an incisional biopsy Perform excisional biopsy Scrape for exfoliative cytology Observe for two weeks Radiation therapy None 13. A patient is diagnosed with an odontogenic tumor and is treated by simple curettage. During follow-up, the lesion recurs because tumor cells had infiltrated beyond the apparent radiographic margins. Which of the following odontogenic tumors is most likely to recur after simple curettage? Complex odontoma Compound odontoma Odontogenic myxoma Ameloblastic fibroma Cementoblastoma None 14. A 12-year-old patient presents with delayed eruption of a permanent tooth. Radiographic examination reveals a well-circumscribed radiopaque lesion composed of dental hard tissues. Histopathology confirms an odontoma. What is the treatment of choice? Excision Resection Curettage Radiotherapy Chemotherapy None 15. A 40-year-old patient is diagnosed with a solid multicystic ameloblastoma of the mandible. Because of its locally aggressive behavior and tendency to infiltrate cancellous bone beyond radiographic margins, what is the treatment of choice? Excision of tumor Resection of the mandible along with the tumor Incisional biopsy and marsupialization No active treatment is necessary Radiotherapy alone None 16. A patient presents with a large odontogenic cyst causing significant bone expansion and lying close to important anatomical structures. The surgeon wishes to reduce the size of the cyst first and then remove the residual lesion definitively. What is the best treatment? Enucleation Marsupialization Marsupialization followed by Enucleation Enucleation followed by Marsupialization Observation only None 17. A patient presents with a 5 cm suspicious lesion of the oral mucosa with irregular borders and features suggestive of malignancy. The lesion is too large to remove completely without a definitive diagnosis. What is the most appropriate management? Incise and send for biopsy Excise and send for biopsy Irradiate Offer palliative treatment Observe for 2 weeks None 18. A surgeon removes a soft tissue lesion from the oral cavity and sends it for histopathological examination. To prevent autolysis and preserve cellular architecture, the biopsy specimen should be immediately placed in: 10% Ethanol 10% Formalin Hydrogen peroxide 1% Formalin Normal saline (for routine histopathology) None 19. A radiolucent lesion of the posterior mandible is aspirated before biopsy. Laboratory analysis shows that the cystic fluid contains less than 4 mg/mL (or Dentigerous cyst Periapical abscess Keratocyst Periodontal cyst Radicular cyst None 20. A benign tumor of the hard palate is surgically removed by enucleation. Because the palatal bone is often thin and lies directly beneath the floor of the nasal cavity, a common intraoperative complication is: Excessive bleeding from nasopalatine vessels Tearing of nasal mucosa Damage to nasopalatine nerve Alteration of speech Injury to greater palatine artery None 21. A 16-year-old female presents with a slowly enlarging radiolucency associated with an unerupted maxillary canine. Histopathological examination reveals an Adenomatoid Odontogenic Tumor (AOT), historically referred to as adenoameloblastoma. What is the treatment of choice? En bloc resection of maxilla Marsupialization Enucleation No treatment Segmental resection None 22. A patient presents with an odontogenic tumor located only 1 cm above the inferior border of the mandible. Because the lesion is very close to the lower border, conservative surgery may leave inadequate bone and increase the risk of recurrence. What is the treatment of choice? En bloc resection Hemimandibulectomy Enucleation No treatment Marsupialization None 23. A patient presents with a large odontogenic cyst causing significant bone expansion and displacement of adjacent structures. To reduce the size of the lesion and preserve vital structures before definitive treatment, the surgeon plans a conservative decompression procedure. Marsupialization is most commonly indicated in: Large cyst Periodontal cyst Aneurysmal bone cyst Stafne cyst Small residual cyst None 24. A 25-year-old patient presents with a slowly enlarging, painless swelling of the maxilla. Radiographic examination reveals a classic ground-glass appearance, and biopsy confirms fibrous dysplasia. The lesion is causing facial asymmetry but no major functional impairment. What is the best treatment? En bloc resection Cosmetic contouring Maxillary resection Radiation therapy Hemimaxillectomy None 25. A patient presents with pain and swelling during meals. Examination and radiographs reveal a sialolith (salivary stone) located within Wharton's duct of the submandibular gland. What is the most appropriate treatment? Dilatation of the duct Excision of the opening of the duct Removal of the gland Incision of the duct and removal of the calculus Radiotherapy None 26. A patient undergoes parotid gland excision (parotidectomy) for a benign salivary gland tumor. Because of the intimate anatomical relationship of several nerves with the parotid gland, which of the following structures are most at risk of injury during surgery? Lesser occipital nerve, hypoglossal nerve, chorda tympani Facial nerve and auriculotemporal nerve Submandibular duct Cervical fascia . Lingual nerve and hypoglossal nerve None 27. A patient complains of recurrent pain and swelling in a salivary gland during meals. Investigation reveals a salivary calculus (sialolith). In which salivary gland are calculi most commonly found? Submandibular gland Sublingual gland Parotid gland Minor salivary gland Labial salivary gland None 28. During surgical removal of a parotid gland tumor, the auriculotemporal nerve is inadvertently damaged. What complication may subsequently develop due to aberrant regeneration of parasympathetic fibers? Facial paralysis Trigeminal neuralgia Gustatory sweating Orolingual paresthesia Loss of taste from anterior two-thirds of tongue None 29. A patient with a submandibular duct (Wharton's duct) calculus requires surgical removal through an intraoral approach. To expose the duct, the surgeon makes an incision in the floor of the mouth through the: Buccinator muscle Mucous membrane Masseter muscle Mylohyoid muscle All of the above None 30. During excision of the submandibular gland for a calculus or tumor, a skin incision is typically placed below the angle of the mandible. Which nerve requires special attention because injury may result in weakness of the lower lip? Ansa cervicalis Marginal mandibular branch of the facial nerve Posterior auricular nerve Submandibular ganglion Greater auricular nerve None 31. A patient presents with a solitary eosinophilic granuloma (Langerhans cell histiocytosis) involving the mandible. Radiographs show a localized osteolytic lesion without evidence of multifocal disease. What is the treatment of choice? Curettage Radiotherapy No treatment needed Chemotherapy Segmental resection None 32. A patient presents with a mucocele of the lower lip, appearing as a soft, fluctuant, bluish swelling caused by rupture of a minor salivary gland duct. To minimize recurrence, what is the treatment of choice? Incision Excision Excision with adjacent glands Biopsy Aspiration None 33. A patient is suspected of having salivary gland duct diverticuli (outpouchings of the salivary duct system). Which imaging modality is most useful for detecting these ductal abnormalities? Ultrasonography Plain radiography Sialography Xeroradiography CT scan None 34. A patient presents with a chronic ulcer on the lateral border of the tongue suspected to be malignant. To obtain a representative tissue sample and maximize diagnostic accuracy, the biopsy specimen should be taken from: Necrotic area Subdermal layer Border of an ulcerated area Center of an ulcerated area Slough-covered surface only None 35. A histopathological examination of a radicular (apical) cyst reveals that the cystic cavity maintains a direct communication with the root canal through the apical foramen. Such a cyst is termed: Residual cyst Bay cyst Paradental cyst Collateral cyst Lateral periodontal cyst None 36. A patient is diagnosed with an odontogenic keratocyst (OKC). Because of the lesion's high recurrence rate, the surgeon performs enucleation followed by application of a chemical cauterizing agent to destroy residual epithelial remnants. Which condition is classically treated using Carnoy's solution? Odontogenic keratocyst Ameloblastoma Dentigerous cyst Mucocele Radicular cyst None 37. A surgeon plans to remove an odontogenic tumor by excising it in one piece along with a margin of surrounding healthy bone, while preserving the continuity of the jaw. This procedure is known as: Complete resection of the jaw bone Resection of half of the affected jaw Resection of the tumor only The entire tumor removed intact with a rim of uninvolved bone while maintaining continuity of the jaw Curettage None 38. After enucleation of a large jaw cyst, a residual bony cavity remains. To promote rapid bone regeneration and healing, which grafting material is considered the most suitable for filling the defect? Hydroxyapatite Autogenous cortical bone chips Autogenous medullary bone chips Allogenic bone chips Xenograft bone chips None 39. A periapical radiolucency is associated with a non-vital tooth. The clinician wishes to differentiate whether the lesion is a radicular cyst or a periapical granuloma. Which of the following methods can be used for this differentiation? Radioopaque dyes (contrast studies) Polyacrylamide gel electrophoresis Biopsy All of the above Pulp vitality testing None 40. An odontogenic keratocyst (OKC) is surgically enucleated. To reduce the risk of recurrence, the surgeon applies a chemical cauterizing agent to the bony cavity to destroy any residual epithelial remnants and daughter cysts. Which agent is used for this purpose? Hydrogen peroxide Carnoy's solution Superoxide solution Betadine Chlorhexidine None 41. A 45-year-old patient undergoes surgical excision of the submandibular gland for chronic sialadenitis. During dissection, the surgeon identifies the deep lobe of the gland extending into the floor of the mouth. Which anatomical relationship of the submandibular gland is most likely to be encountered during the procedure? Damage to the lingual nerve will cause loss of sensation to the posterior third of the tongue The submandibular gland is seen to wrap around the posterior border of the mylohyoid The facial artery and vein are usually divided as they course through the deep part of the gland The hypoglossal nerve is seen to loop under the submandibular duct The lingual nerve supplies the posterior third of the tongue None 42. A 19-year-old patient presents with a painless, bluish, fluctuant swelling in the floor of the mouth. Clinical examination and imaging confirm a ranula arising from mucus extravasation of the salivary glands in the floor of the mouth. To minimize the risk of recurrence, which gland is typically removed during surgical treatment? Submandibular gland Sublingual gland Parotid gland Lacrimal gland Minor palatal salivary glands None 43. A 52-year-old patient presents with recurrent painful swelling of the left submandibular region during meals. Imaging reveals a large calculus located within the substance (parenchyma) of the submandibular gland, rather than in Wharton's duct. What is the most appropriate treatment? Removal of sinus Removal of the gland Dichotomy Milking of the stone Duct incision and stone retrieval None 44. A 24-year-old patient presents with a soft, fluctuant swelling in the upper neck below the mandible. Intraoral examination reveals minimal swelling in the floor of the mouth. Imaging demonstrates a mucus collection originating from the sublingual gland and extending into the neck through a defect in the mylohyoid muscle. This lesion is best described as a plunging ranula. Why is it called "plunging"? Its large size Lifting of the tongue Extension through the mylohyoid muscle Involvement of the lingual nerve Extension into the parotid gland None 45. A 58-year-old man is diagnosed with squamous cell carcinoma (SCC) of the lateral border of the tongue. Clinical staging is T2N0M0, with no palpable cervical lymph nodes. Because occult cervical metastasis is a concern, elective neck management is planned along with excision of the primary tumor. Which neck dissection is most appropriate? Supraomohyoid neck dissection (Levels I–III) Removal of lymph nodes Levels I–II Removal of lymph nodes Levels I–V Removal of lymph nodes Levels I–IV Radical neck dissection None 46. A 62-year-old patient is diagnosed with squamous cell carcinoma of the mandibular alveolus. The surgeon plans a composite excision following the principles described by Gold, Upton, and Marx. The goal is to achieve complete tumor clearance while minimizing the risk of local recurrence. What does composite excision involve? Resection of the tumor with the entire wound Resection of the tumor leaving the marginal bone intact Resection of the tumor with unaffected neighbouring tissue Resection of the tumor with wide margin excision Simple enucleation of the lesion None Time's up
