O.494 Multifocal malignant melanoma of the paranasal sinuses: case report

S124

Journal of Cranio-Maxillofacial Surgery 36(2008) Suppl. 1

was still 55.2% but for MSGT it dropped to 48.4% because of late recurrences of adenoid cystic carcinoma’s (ACC). The success rate of therapy for a local and/or regional recurrence is very limited. Patients with a second primary tumour (SPT) can be cured if the tumour is detected in an early stage. In contrast to MSGT treated patients, routine follow-up for SCC used to detect local recurrence or SPT has almost no value after five years and seems of limited value after three years. O.494 Multifocal malignant melanoma of the paranasal sinuses: case report G. Mancini, A. Marzetti, B. Mafera, M.G. Vigili. Ospedale S. Carlo – IDI Sanit`a, Rome, Italy Female patient of 52 years, comes to our observation on December 2002 for unilateral recurrent epistaxis. In endoscopy video, was highlighted training polypoid, brownish occupying the all right nasal fosse. It was performed a biopsy of the lesion. It was performed CT of the skull and MRI total body with gadolinium, that showing a solid expansion of homogeneous density involving the turbinate medium and the ethmoidal cells. The imaging excluded repetitive injuries to the brain and to the distance. She was submitted to paralateronasal approach, was performed an right ethmoid-maxillectomy with ablation of medium turbinate and nasal mucosa. Then has followed 5 cycles of chemo-therapy with interleukin 2 and deticene. Controls that are followed for the next three years were negative. During the fourth year of follow-up CT of massive facial showed a thickening of the mucosa of turbinate contra lateral lower. The subsequent nasal endoscopy confirmed the presence of a lesion that brownish biopsy confirmed epitelioid be a melanoma. She was submitted to endoscopic treatment. Controls that are followed for the next 18 months were negative. Discussion: According to reports in the literature as the seat of mucosal melanoma reported by us is the most frequent. In contrast to the extension stations loco-regional lymph node was not found in our case. Interestingly however, the particular location of multiple injuries because of their anatomical distance and time. Conclusion: The AA accordance with the international literature, to consider today that surgical resection offers the best chance of survival for mucosal melanoma. Shall not be deemed necessary treatment instead Ablative station local-regional lymph node, locations which are not reported as influential prognostic purposes. Of utmost importance, however, is the early diagnosis O.495 Multimodal therapy of 276 patients with advanced oral cancer

Abstracts, EACMFS XIX Congress Kaplan-Meier method was used to estimate overall survival and local control. The log-rank test was used for comparison of survival- and local control curves of different groups. Results: Median surveillance period was 101.4 months (24– 202 months). 5-year overall survival probability was 53.9% and 5-year local control probability was 70.2%. In respect to 5-year overall survival statistical analysis showed a significant difference between responders (RG1 and 2, n: 170) and non-responders (RG3 and 4, n: 85). Summary: Our results underline the long-term liability of preoperative radiochemotherapy and radical surgery in the treatment of advanced oral cancer. O.496 Neck dissection. Survival analysis and treatment proposals G. Koloutsos, A. Domouhtsis, A. Kyrgidis, N. Kechagias, D. Mangoudi, C. Tsombanidou, K. Kitikidou, K. Vahtsevanos, K. Antoniades. Theagenion Cancer Hospital, Thessaloniki, Greece Objectives: Neck dissection, radical (RND), modified radical (MRND) and selective (SND) is a major surgical procedure often followed by important disability and complications. Still it is an essential procedure in the treatment of metastatic head and neck cancer disease. Methods: From 1995 till 2007 we treated 121 patients with RND, MRND and SND. Most patients suffered from squamous cell carcinoma (SCC) there were 10 patients with melanoma of the facial region and 5 with salivary gland cancer. Kaplan Meier survival analysis was performed with patient data. Possible predictors of survival were analyzed in a Cox proportional hazards model. Results: 92 men and 29 women compose our sample. The mean age of our patients was 63±12 years. The prevalence of head and neck SCC in our sample was higher in women aged over 60 years (p < 0.001) but not in men. Skin and salivary primary localization was infrequent among patients aged less than 60 years (p = 0.015). Median survival was 30, 23 and 24 in patients treated with RND, MRND and SND respectively while it was 10 months in patients where SND was followed by RND. These results did not reach significance (p = 0.472). The recorded variables were not able to predict risk of death (p = 0.610) in a Cox model. Conclusion: The data derived from our series cannot suggest one neck dissection technique over the others. A minor trend in favor of RND is not statistically significant. More patients and studies are needed to provide better evidence for treatment choice and prognostic factors. O.497 Neoplasm of craniofacial skeleton in childhood

C. Nell, D. Berzaczy, W. Millesi, R. Ewers, C. Klug. Hospital of Cranio-Maxillofacial and Oral Surgery, Medical University of, Vienna, Austria

F. Maggiulli, G. Spuntarelli, S. Latorre, L. Santecchia, M. Zama. Ospedale Pediatrico Bambino Ges`u, Roma, Italy

Introduction: Aim of this study was to analyse survival and locoregional control in patients with advanced oral and oropharyngeal squamous cell carcinoma treated by multimodal therapy with preoperative radiochemotherapy and radical surgery. Patients and Methods: By December 31, 2006 a minimum follow-up of 24 months was reached for 276 consecutive patients who underwent multimodal therapy from January 1, 1990, to December 31, 2004. Included in this analysis are patients with UICC disease stages III and IV (III: 16.3%; IV: 83.7%). All patients received preoperative radiochemotherapy (50 Gy, Mitomycin and 5-Fluorouracil) and radical locoregional resection after a regeneration interval of 4 to 6 weeks. Histopathology of resected tumours was analysed with regard to response to RCT and classified in histopathological grades of regression (RG1: no vital tumour cells, RG2: minimal tumour remnants encompassing less than 5%, RG3: 5 to 50% vital tumour cells, RG4: more than 50% vital tumour cells). The

Neoplasms in pediatric population are relatively frequent but malignancies are really rare. This is the reason why the diagnosis of these lesions is often late: the growing lesions are initially underestimated or misdiagnosed. This fact is very important since malignancies in childhood are very sensitive to medical treatment and late diagnosis can be fatal. Benign lesions often necessitate wide excision to prevent recurrence. Extensive demolition of facial or mandibular skeleton require reconstructive procedures that go from cranial or rib bone grafts to free fibular flap. Mandibular reconstruction can also be achieved through distraction osteogenesis with bone transportation. Malignancies, as stated before, are very sensitive to medical treatment so early diagnosis through open biopsy is mandatory for the correct oncological treatment. Sometimes wide excision is required and reconstructive procedure with free flaps are indicated.