involved a 78 year old man with submandi bular gland ductal carci- noma who presented with a lesion adjacent to Wharton duct. The second case is a woman of 77 years, with a history of ductal carci- noma of the parotid gland, that debuted three years later with of alytic lesion ipsilateral in the parasymphyse al mandibula r area.

Results: After excluding both distant metastatic disease, we stud- ied the vascularizat ion of tibial–peroneal trunks, underwent surgery by perform ing a wide resection , and a microsurg ical reconstruct ion with fibular flap. Pathological ly confirmed diagnos tic of ductal carci- noma with free surgical margins and high-gra de of perineural and vascular invasio n in both cases. Immunohisto chemistry studies per- formed confirmed negative results for ERB-2 gene amplification.

Discussion: Ducal carcinoma of the salivary glands is a rare adeno- carcinoma generated from the glandular excretory duct cells.Despite his aggressiv eness, poor prognosis and unpredictab le clinical course, wide excision with ipsilate ral cervical lymph node dissect ion and adjuvant radiot herapy are supported as the treatment of choice for local and regional control of disease. In advanced cases with dis- tant metastases, studies have shown favorable results after treat- ment with trastuzum ab, a monocl onal antibody selective for ERB-2 also expressed in ductal breast carcinoma .

Conclusions: Salivary duct carcinoma has a low surviva l rate,which despite surgery with adjuvant radioth erapy offers the best therapeuti c weapon, including the possibilit y of new treatment semerging from the immunoh istochemica l studies.

doi:10.1016/j.oraloncolo gy.2013.03.421

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Chondroi d syringo ma of the medial canthal: Case report Konstantino s Paraskevop oulos a, Angeliki Cheva b,Ioannis Matzarak is b, George Koloutsos a, Nikolaos Kechagias a,Konstantino s Vahtsevan os a

a Department of Oral and Maxillofaci al Surgery, General Hospital G.Papaniko laou, Thessalo niki, Greece b Departme nt of Pathology, General Hospital G. Papaniko laou, Thessa- loniki, Greece

Chondroi d syringoma, or Pleomorph ic adenoma of the skin, is arare, benign skin adnexal tumou r. It is usually exhibited as a slowly growing intradermal or subcuta neous nodule, typically locate d inthe head and neck region. Because of the unremarkab le clinical symptomat ology of this rare tumour, the diagnosis is exclusively made retrospec tively based on histologi cal confirmation of the surgi- cally excised tumour.

We present a rare case of a Chondroid Syringoma located in the left medial canthal of a 58-year- old man. The patient had no symp- toms and decided to excise it for cosmetic reasons only. Local exci- sion with a macros copic wide cuff of normal tissue was done,without destroy ing the aesthetic and functional structure s, since the defect was restored by a finger flap. One year postope ratively,the patien t has remained disease-free . Chondroi d syringoma usually appears in the face but the location in the medial canthal is not men- tioned in the literature the last twenty years.

doi:10.1016/j.oraloncolo gy.2013.03.422

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Reconstru ction of total lip defect by mean of composi te fascioc- utaneos free flap

David González Ballester, Isidoro Rubio Correa,Cristina Hernández Vila, Manuel Moreno Sánchez, Luis Ruiz Laza,Manzano Damián Sólo de Zaldı́var, Raúl González Garcı́a,Florencio Monje Gil

Departme nt of Oral and Maxillofaci al Surgery, University, Hospital Infanta Cristina, Badajoz, Spain

Purpose: To show our experience in the reconstruct ion of total lip defects by means of composite fasciocu taneous – palmaris longus tendon free flap.

Methods: Three men with a mean age of 66.33 years (range: 54–73) were diagnosed with squamous cell carcinoma of the lip region (2 of the lower lip and 1 of the upper lip). Sixty-si x percent ofpatien ts received radiotherap y as the first choice of treatment , being necessar y subseq uent surgery for recurren t disease. All patien tswere reconstru cted using the composite radial forearm – palmaris longus tendon free flap. In all cases, the tendon of palmari s longus was anastomosed to the orbiculari s oris muscle.

Results: At a mean follow-u p of two years (range: 1–3) no signs of locoregiona l recurren ce were observed . A good aesthetic and function al result were obtained in all patien ts, achieving an excel- lent lip compet ence. No postope rative complicatio ns were per- ceived. All patients were satisfied with their final reconstructi veresult.

Conclusions : Lip reconstruct ion is a challenge for the head and neck surgeon. In situations where large defects are originated after wide resections , reconstruct ion with composite microvasc ular flapsconstitu tes an excellent option.

doi:10.1016/j.oraloncology.2013.03.423

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17 years – Microv ascular fibula flap sandwiched between the fibula and mandib le segments: Variant VII L.M. Sassi a, J.L. Dissenha b, M.I. Guebur b, R.R. Bixofis b, A.B. Silva d,A.C. Groth d, P.A.G. Pedruzzi c, G.H.A. Ramos c, B.V. Oliveira c

a Departme nt Chif of Oral and Maxillofaci al Surgery of the Erasto Gaertner (Oncology) Hospital of Curitiba, Paraná, Brazil b Department of Oral and Maxillofaci al Surgery of the Erasto Gaertner (Oncology) Hospital of Curitiba, Paraná, Brazil c Department of Head and Neck Surgery of the Erasto Gaertner (Oncology) Hospital of Curitiba, Paraná, Brazil d Departme nt of Plastic Surgery of the Erasto Gaertner (Oncology)Hospital of Curitiba, Paraná, Brazil

Introductio n: Beyond the resection of a tumor of the face, recon- struction and return of function and esthetics.

Objective: To present a new method of reconstructi on of the mandible .

Method: The patient NMM (Erasto Gaertne r Oncolog y Hospital –Brazil) 39 years old, caucasian female, had a diagnosis of amelo- blastoma in body and ramus of the right mandible . The proposed technique used vascularized fibula flap divided into two segments,the first for reconstruct ion of the mandibula r body to the right and the second to reconstruct the branch of the jaw, with vascular pedicle and bone fixation with titanium mini-plates and screws.To the construction of the socket was created a gap or niche inthe higher cortical fibular segment in the region of the mandibula rbody and, in the jaw angle region of the crack length equal to the thickn ess of the fibula and the equivalent width of 50%. It was made a cut in the segment of the fibula that will rebuild the ascending branch of the jaw, preparing a gap of approximatel y

S154 Abstracts / Oral Oncology 49 (2013) S93–S156