PP019

Evaluati ng the capacity of Syrian dentists in diagnosis of oral cancer and precance r lesions Omar Hamadah, Huda Yahia, Zainab Sabag

Departme nt of Oral Medicine, The Dental School, Dama scus University,Syria

Purpose: Early diagnosis is a crucial step for reducing cancer mor- bidity and mortalit y. Initial detection of precancer ous lesions essen- tially relies on the vigilance of dentists working in primary healthca re.

The aim of this questionnair e-based study was to evaluate the ability of dentists practicing in Damascu s to correctly diagnose potentially malignant lesions. This informatio n serves as a base line to ascertain educatio nal needs of dentists in the Damascus area.

Subjects and method s: 93 dentists completed a study question naire comprisin g 9 questions assessing experience and knowledg e of diag- nostic techniques for oral cancer and precancer and 21 clinical cases includin g 7 oral cancers, 7 oral precancers, and 7 benign lesions .Dentists were asked to determine the type of each lesion, the need for biopsy, and a management plan for each case.

Results: No correlation was found between correct diagnos is oflesions and number of years clinicians had been registered dentists.In total, 37% of participant s had perform ed at least one incisional biopsy during their profession al life, 69% of them were unable tocarry out a brush biopsy or to apply toluidine blue (84%). 95%responden ts had never attended any course concerning oral diagnos -tic methods, but 77% of dentists had referred patients with poten- tially malignant oral mucosal lesions.

Only 5% responden ts correctly identified all clinical cases. Sur- prisingly, 9% of responden ts failed to identify benign lesions cor- rectly, 18% of precancer lesions, and 29% of cancer lesions.

Conclusions: This study emphasize s a need for improvi ng the clin- ical diagnost ic ability of dentists practicin g in Damasc us in order that patients who might benefit from early precancer interventio nare not missed. We believe that reviewing the undergraduat e oral medicine curriculum providin g oral medicine education opportuni -ties at a postgrad uate level will improve the current situation.

doi:10.1016/j.oraloncolo gy.2013.03.262

PP020

Extrame dullary maligna nt tumor s in the head and neck region – A case report Aleksi Schrey a, Elina Halme b, Sami Ventelä a, Jukka Laine c,Heikki Irjala a

a Dept. of Otorhinolaryn gology – Head and Neck Surgery , Turku University Hospital, Turku, Finland b Dept. of Otorhino laryngology – Head and Neck Surgery , Tampere University Hospital, Tamper e, Finland c Dept. of Pathology, Turku University Hospital, Turku, Finland

Extramedu llary malignant tumor refers to a malignant tumor ofbone marrow origin arising outside the bone marrow. The most common ones on the head and neck region are plasmacyto ma and myeloid sarcoma. Of these two, plasmacytoma is more comm on,though it still is rare consisting only 0.4% of all hematolo gical malig- nancies. It is slowly growing, typically located submucosal ly and it isassociat ed to multiple myeloma.

Myeloid Sarcoma (MS) consists of immatu re myeloid cells and itis often associat ed with acute myeloid leukemia (AML). Rapid

growth is typical for myeloid sarcoma. A diagnosis of MS is based on immunohist ochemistry and differential diagnos tics can be chal- lenging. Treatment of MS is always systemic and surgery is used only for decompr ession.

Case report: 34y male fire fighter was sent to ORL consultation due to right nostril obstruction . He had allogenic bone marrow trans- planta tion for AML five years earlier and the disease had been inremiss ion. A solid prominence was palpable on the right maxillary bone. CT and a sublabial biobsy were performed. After several immu- nohisto chemical analyses the tumor was defined as MS and the patien t received induction chemothera py. Now patient has had aconsolida tion course, but new bone marrow transplan tation has not been done due to severe infection problems.

Conclusion: biopsy should not be hesitated when treating patien ts with atypical swelling symptoms especially if the patien thas a history of hematolo gic disease. It is also important toremem ber that the treatment of head and neck tumor is not always surgical.

doi:10.1016/j.oraloncology.2013.03.263

PP021

Fluores cence spectrosco py for evaluati on of safety margins inindividua ls with squamou s cell carcinom a of the oral cavity surgicall y treated Ana Lucia Noronha Francisco a, Wagner Rafael Correr b,Clóvis Antônio Lopes Pinto c, Cristina Kurachi b, Luiz Paulo Kowalsk i a

a Departme nt of Head and Neck Surgery and Otorhinolaryn gology, A.C.Camargo Hospital and Nationa l of Science and Technolog y, Institute inOncogen omics (INCITO), São Paulo, Brazil b Department of Physics and Materials Science, Physics Institute of SãoCarlos, University of São Paulo (USP), São Paulo, Brazil c Department of Pathology, A.C. Camargo Hospital, São Paulo, Brazil

Oral cancer is a public health problem with high incidence inthe Brazilian population. The affected patien t usually presents for clinical investigat ion, with advanced stage disease, the conse- quence of this delay is a reduction in survival rates. Given this,it’s essential to detect oral cancer in early stages. Fluoresce nce spectrosc opy is a non-invasi ve diagnostic tool that can aid in can- cer detection in real time, technique is relativel y simple, fast and accurate which evaluate s the bioche mical compositio n and struc- ture of the tissue fluorescence spectrum emitted by it, after appli- cation of a light source.

The aim of this study was to discriminate, in the oral mucosa,healthy tissue, tumor and limits of the tumor, through fluorescence spectrosc opy.

The sample consisted of 100 individual s who were submitted tofluorescence spectroscopy , of whom 50 patien ts had oral carcinoma cell squamous and 50 volunteers with normal oral mucosa. 62% were male and the mean age was of 53.5 years. The spectra were classifiedand compared to histopath ology for determining the efficiency indiagnos tic discriminati on employing fluorescence. The statistical analysis consisted of various types of mathemat ical processing ofspectra . It can be observed variability among the anatomical sites among individual s, among regions of the injury and among the safety margins of the tumor. The specificity and sensitivit y of the technique varies dependin g on the type of statistical analysis employ ed, and we can see its potential use as an aid to diagnosis of oral cancer.

doi:10.1016/j.oraloncology.2013.03.264

S100 Abstracts / Oral Oncology 49 (2013) S93–S156