P1.27. Malignant odontogenic tumours: A retrospective study of 11-years

P1.24. Mucoepidermoid carcinoma of palatal salivary glands: Clinicopathological experience with 10 patients M. Meleti *, S. Ferrari, L. Toma, P. Vescovi, E. Sesenna University of Parma, Italy Introduction: Mucoepidermoid carcinoma (MEC), constitutes approximately 30% of all salivary glands malignancies. On the basis of histopathological features, MEC is usually subclassified as low, intermediate or high grade. Complete excision of the lesion with free surgical margins is the treatment of choice. Prognosis depends on adequacy of treatment, clinical stage, tumour grade and location. Methods: The experience with 10 patients (7 M, 3 F; mean age 46.2 years) with primary MEC of the palate, referred to the Unit of Oral and Maxillofacial Surgery of the University of Parma, Italy, between 1998 and 2008 is presented. Hard palate was the affected site in 7 patients. In 3 cases lesions were localized to both the hard and soft palate. Frequently reported clinical manifestations include presence of a non-painful, slowgrowing mass. According to the clinical staging system for salivary gland tumours, 9 patients were subclassified as stage I (T1N0M0) and 1 patient was subclassified as stage III (T3N1M0). Histopathologically, 6, 1 and 2 cases were reported as low, intermediate and high grade MEC, respectively. No histopathological grading was provided in one report. Results: All patients received surgical excision of the tumour as treatment of choice. Simultaneous neck dissection was performed in one case with presence of preoperatively confirmed neck lymph nodes involvement. According to the histopathological reports, surgery was ‘‘radical”, ‘‘not radical” and ‘‘questionable” in 6, 2 and 2 cases, respectively. Post-operative radiotherapy was administered in one patient. Regional lymph node metastasis after 4 years occurred in one case. No patient experienced recurrence or distant metastases in a mean follow-up of 63.5 months Discussion: Our experience confirms that MEC of palatal salivary glands mainly occur between the 4th and 6th decades. In this series, prognosis seems to depend on radicality of surgical excision, regardless of histopathological grade. doi:10.1016/j.oos.2009.06.310

P1.25. Parotidectomy for benign parotid tumors: An aesthetic approach A. Amin a, A. Mustafa a,*, A. Nabawi b, M. Shallan a, A. Rabie a, M. Refaat a a b

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P1.26. Intraoral and oropharyngeal minor salivary gland malignant neoplasms: Review of 315 patients treated in a single institution G. Duque, M.V.M. Camara, F.L. Dias *, R.A. Lima, U.B. Toscano Jr., F.G. Botelho Department of Head and Neck Surgery of the Brazilian, National Cancer Institute – INCa/ Rio de Janeiro, Brazil Oral Pathology Area, Federal University of Uberlândia, Uberlândia, Brazil Background: Minor salivary gland cancer (MSGTs) accounts for 2–4% of head and neck cancer, 10% of all cavity cancer and 15–23% of all salivary glands cancer. This study reviews a large series of malignant intraoral and oropharyngeal MSGTs, and determines the incidence and correlation of the histopathologic features with the clinical characteristics. It also searches for independent prognostic factors for locoregional control, distant metastases, and survival. Methods: Three hundred and fifteen cases of MSGTs treated at the Brazilian National Cancer Institute between 1997 and 2007 were retrospectively studied. Clinical and histopathological characteristics were also noted. Analysis for the potential prognostic impact of demographic, clinical, therapeutic, and histopathologic variables was undertaken. Tumors were classified according to the 2005 WHO classification. Results: The rates of 5-years disease-free and overall survival were 77.21%, and 69% respectively. The majority of our patients were female (53.6%) between 40 and 60 years old (44.2%). The percentage of intraoral tumors was 78.2% in comparison with 21.8% of oropharyngeal tumors. The most frequent intraoral sites were; hard palate 54.6%, buccal mucosa 19.7%, and floor of mouth 10.4%. The most frequent oropharyngeal sites were; soft palate 52.4%, and tongue base 43%. Most of our patients were classified as stages I (26%) and II (35%). Lymph node metastases were identified in 11% and distant metastases in 4% of cases at presentation. Surgery with or without adjuvant radiotherapy was the main therapeutic strategy employed (29.5% and 49.5%, respectively). Mucoepidermoid carcinoma, adenoid cystic carcinoma, and adenocarcinoma were the most frequent histological types found with 34.5%, 32.3%, and 28.2% respectively. Locoregional control and survival was predicted by clinical T-stage, bone invasion, site, resection margin, and treatment. Conclusions: Several prognostic factors for locoregional and distant control were found. Radical surgery with postoperative radiotherapy was found to improve locoregional control. doi:10.1016/j.oos.2009.06.312

National Cancer Institute, Cairo University, Egypt Department of Surgery, Alexandria University, Egypt

Tumors of the parotid gland represent 80% of salivary gland neoplasm, of which 80% are benign tumors. Although patients with malignant lesions typically present after the age of 60 years, benign tumors usually present after the age of 40 years and occur more frequently in women than in men. Conventional techniques of parotidectomy cause varying degree of cosmetic deformity in the form of visible scar, facial contour disfigurement, numbness of the ear, and occasionally gustatory sweating. We present our experience at the national cancer institute removing both superficial and deep lobe parotid tumors utilizing a comprehensive cosmetic approach through facelift incision, preservation of great auricular nerve and reconstruction with sternomastoid flap in a total of 21 patients from 2005 to 2008. doi:10.1016/j.oos.2009.06.311

P1.27. Malignant odontogenic tumours: A retrospective study of 11-years D. Costa a, J. de Assis Silva Júnior a, N. Moraes a, A. Mauricio a,b, P. Faria a,c, S. Lourenço a,* a Pathology Post Graduation Program – Fluminense Federal University (UFF), Brazil b Anatomic Pathology Service – Army Central Hospital (HCE-RJ), Brazil c Pathology Division – National Cancer Institute (INCA-RJ), Brazil

Introduction: Odontogenic tumours are uncommon lesions of the mandible and maxilla that constitute less 4% of all oral specimens. Malignant neoplasm account for a minimum percentage of all odontogenic tumours and the according to diverse series published they represent between 1.0% and 6.0%. The aim of this study was to determine the frequency and clinical features of malignant odontogenic tumours in three different Anatomic Pathology Services.

Poster Abstracts Oral AbstractsPoster ListOrals ListPan. Disc. & Symp. Abs.Keynote Abs.Keynote Bios.ProgramIAOOWelcomeCommittee Listings

Poster session I / Oral Oncology Supplement 3 (2009) 123–161

Poster Abstracts Oral AbstractsPoster ListOrals ListPan. Disc. & Symp. Abs.Keynote Abs.Keynote Bios.ProgramIAOOWelcomeCommittee Listings

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Poster session I / Oral Oncology Supplement 3 (2009) 123–161

Methods: We selected all cases with diagnosis of malignant odontogenic tumours of the Anatomic Pathology Service of the Antonio Pedro University Hospital, National Cancer Institute and Army Central Hospital seen from January 1997 to December 2007. The final diagnosis was based on histological criterions published by WHO1 in 2005. Results: Only 7 cases were diagnosed of malignant odontogenic tumours and represented 4.1% of the 168 odontogenic tumours. No case was found in Army Central Hospital. The tumours were three cases of ameloblastic carcinoma (secondary type), one of ameloblastic fibrosarcoma, clear cell odontogenic carcinoma and primary intraosseous squamous cell carcinoma derived from keratocystic odontogenic tumour. The mean age of patients was 45 years-old (range 26–62 years). There was on overall male to female ratio of 5:2 and mandible to maxilla ratio was 5:3. The clinical features were symptoms in six cases and increase of volume in all cases. Four lesions recurred and two patients died. Discussion: The small number of series published worldwide is due to rarity, scant clinical information, and similar histopathologic image that many of these tumours have in common with benign odontogenic tumour. This study confirmed that the malignant odontogenic tumours are rare, demonstrated an aggressive course with wide destruction and frequent recurrences. Financial support: CAPES. doi:10.1016/j.oos.2009.06.313 Further reading 1. Barnes L, Eveson JW, Reichart P, Sidransky D. Pathology and genetics of head and neck tumours. WHO classification head and neck tumours. Lyon: IARC Press; 2005. 2. Goldenberg D, Schiubba J, Koch W, Tufano RP. Malignant odontogenic tumors: a 22-year experience. Laryngoscope 2004;114:1770–4. 3. LU Y, Ming X, Takashi T, Changmei W, Zhixiu H, Zhiyu Z, et al.. Odontogenic tumors: a demographic study of 579 cases in Chinese population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;86:707–14. 4. Taylor AM, Montes CL, Sandoval SC, Robertson JP, Rivera LMRG, Garcı´a AM. Odontogenic tumors in México: a collaborative retrospective study of 349 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;84:672–5. 5. Taylor AM, García AM, Rivera LMRG, Roa MLSR, Ortiz KL. Tumores odontogénicos malignos. Estudio retrospective y colaborativo de 7 casos. Med Oral 2003;8:110–21.

P1.28. Dentinogenic ghost cell tumor of the maxilla M. Quinn, M. Brace, R. Hart, J.R.B. Trites, M. Bullock, S.M. Taylor * Dalhousie University, Canada We present an interesting case of a Dentinogenic ghost cell tumor (DGCT) in a 74 year old male patient who was evaluated for an asymptomatic mass on the right maxillary tuberosity. A biopsy of the mass revealed epithelial proliferation with irregular nests of cells, resembling ameloblasts. At the centre of the nests, keratinized ‘‘ghost” cells and amorphous calcified material resembling dentin were identified and the diagnosis of a DGCT was established. The patient was treated by means of an infrastruc-

ture transoral maxillectomy and was reconstructed with a buccal fat pad transfer and a palatal obturator. All margins were negative and the patient has been followed for one year and has been free of recurrence. Dentinogenic ghost cell tumor (DGCT) is a rare, solid, neoplastic variant of the calcifying odontogenic cyst characterized by ghost cell keratinization within the proliferative epithelium and a large amount of dentinoid. DGCTs are benign tumors and are typically treated by local resection or enucleation. Although the literature surrounding centrally occurring DGCTs is limited, recurrence of the tumor following resection remains a major concern. The presentation, histology and treatment of this rare tumor will be discussed and the diagnosis should be considered in any patient presenting with a relatively asymptomatic mass of the maxillofacial skeleton. doi:10.1016/j.oos.2009.06.314

P1.29. In situ application of cyanoacrylate glue as primary or adjuvant treatment of oral vascular malformations: Report of three cases G. Venetis, A. Ntomouchtsis *, L. Zouloumis, A. Triantafyllidou Aristoteles University of Thessaloniki, Greece Objective: Cyanoacrylate is a slowly absorbable tissue glue. This study reports preliminary results for the use of glubran 2 (GEM, Viareggio, Italy) after injection in oral vascular dysplasias. Patients and methods: Six cases of oral vascular dysplasias are presented with regard to their clinical, radiological and histological follow up. Patient 1 presented with a fibroma of the upper lip, developing on a large hemifacial hemangioma, which was resected after cyanoacrylate injection. Patient 2 presented with a vascular tumor non susceptible to embolism at the middle of the tongue, and received the same treatment as patient 1. Patient 3 had multiple small hemangiomas at the left gingicobuccal sulcus and lower lip, patient 4 had a vascular lesion at the mucosal site of oral commissure, patient 5 a multiextruded vascular malformation of the buccal mucosa and patient 6 had multiple small hemangiomas all over the right half of the tongue, treated with intralesion injection of glubran 2, alone.Patients 3,4,5 and 6 were treated with intralesion injection with luebran 2, alone. Results: All patients had complete remission in a mean 7 months follow up. Two of them had post-op digital angiography, showing satisfactory healing of the vascular supply at the bed of the lesion. Wound dehiscence and necrotic ulceration was observed in two cases. Histology was performed immediately after glubran injection in two patients and in one of them six months later, showing fibrous tissue formation at the site. Soreness for 4– 5 days was the chief complain in two of the patients and hard palpable masses were detectable at the injection sites for more than 1 month. Conclusion: Taking into account the side effects of cyanoacrylate injection referred in the literature, glubran could be an alternative in cases of oral vascular dysplasias where (a) long-term vascular seal is needed; (b) endovascular embolism is not feasible and (c) surgical treatment alone is not adequately safe. doi:10.1016/j.oos.2009.06.315