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Youn SB, Myoung H, Kwon IJ. Squamous cell carcinoma of lower lip: the results of wide V-shaped resection. J Korean Assoc Oral Maxillofac Surg 2023; 49:292-296. [PMID: 37907345 PMCID: PMC10618663 DOI: 10.5125/jkaoms.2023.49.5.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/30/2023] [Accepted: 03/01/2023] [Indexed: 11/02/2023] Open
Abstract
Generally, if the size of a lip cancer defect exceeds 30% of the lower lip, a local flap or free flap is recommended. However, defects up to 50% of the lower lip in size have been reconstructed successfully by primary closure without a local flap or free flap. In one case, an 80-year-old male farmer who had smoked for more than 50 years presented with squamous cell carcinoma of the lower lip and underwent mass resection and supraomohyoid neck dissection. The defect accounted for almost 2/3 of the lower lip and was repaired by primary closure with V-shaped resection. Biopsy results confirmed pT2N0cM0 stage II disease with clear margins. In another case, a 68-year-old male also presented with squamous cell carcinoma of the lower lip and underwent mass resection. The defect accounted for about half the size of the lower lip but was repaired by primary closure with V-shaped resection. Both patients experienced no discomfort while eating or speaking and were satisfied with the cosmetic and functional outcomes with no evidence of recurrence. Thus, direct closure can be considered even in large lower lip cancers.
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Affiliation(s)
- Sung Bin Youn
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hoon Myoung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
- Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Ik-Jae Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
- Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Hwang JR, Khachemoune A. Lower lip basal cell and squamous cell carcinomas: a reappraisal of the similarities and differences in clinical presentation and management. Arch Dermatol Res 2023; 315:117-125. [PMID: 35312855 DOI: 10.1007/s00403-022-02345-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/26/2021] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
Abstract
Basal cell carcinoma and squamous cell carcinoma are the two most common types of carcinomas, affecting a total of 5.4 million people each year in the United States. Sun-exposed areas, especially the face and nose, are most affected given the strong association between these carcinomas and ultraviolet radiation. Less research has been done surrounding carcinomas of the lip, despite the significant aesthetic and functional importance of this area. Although lip carcinomas tend to follow a classic, unique distribution pattern that favors basal cell carcinoma on the upper lip and squamous cell carcinoma on the lower lip, more cases of lower lip basal cell carcinoma are being reported, warranting further educational awareness to differentiate carcinomas of the lower lip. In this article, we provide an updated overview of the risk factors, presentations, differential diagnoses, metastatic risks, evaluation, management guidelines, and outcomes of lower lip carcinoma. Of note, recent advances in imaging modalities are beginning to show promise as a non-invasive, affordable, and rapid way to detect and stage tumors. We conclude that increased clinical awareness and investigation of lower lip carcinoma is needed to improve early intervention, as a delayed diagnosis can rapidly alter the management and outcomes of lip carcinomas.
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Affiliation(s)
| | - Amor Khachemoune
- Veterans Affairs Medical Center, State University of New York Downstate, 800 Poly Place, Brooklyn, NY, 11209, USA. .,SUNY Downstate, Brooklyn, NY, USA.
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Lallas A, Martínez G, Arceu M, Kyrgidis A, Liopyris K, Brancaccio G, Longo C, Errichetti E, Sgouros D, Papageorgiou C, Fotiadou C, Siskou S, Manoli SM, Sotiriou E, Ioannides D, Katoulis A, Lazaridou E, Todorovska V, Argenziano G, Apalla Z. Clinical and dermatoscopic predictors of squamous cell carcinoma of the lips: a case-control, multicentric study. J Eur Acad Dermatol Venereol 2021; 36:222-227. [PMID: 34743367 DOI: 10.1111/jdv.17790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/29/2021] [Accepted: 10/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Squamous cell carcinoma of the lip accounts for 20% of all oral carcinomas. Its diagnosis may be challenging because it clinically resembles actinic cheilitis and inflammatory lesions of the lips. OBJECTIVES To determine clinical and dermatoscopic predictors of squamous cell carcinoma of the lip vs. other lip lesions. METHODS Multicentre retrospective morphological study, including histologically confirmed cases of squamous cell carcinoma of the lip and controls consisting of actinic cheilitis and inflammatory lesions of the lips. Clinical and dermatoscopic images were evaluated for the presence of predefined criteria. Crude and adjusted odds ratios and corresponding 95% confidence intervals were calculated by univariate and multivariate logistic regression respectively. RESULTS A total of 177 lip lesions were evaluated, 107 (60.5%) were squamous cell carcinomas and 70 (39.5%) were controls. The most frequent dermatoscopic criteria of lip squamous cell carcinoma were scales (100%), white halos (87.3%) and ulceration (79.4%). The majority of squamous cell carcinomas displayed polymorphic vessels (60.8%), with linear (68.6%) and hairpin (67.6%) being the most frequent types. Multivariate logistic regression analysis showed that clinical predictors of lip squamous cell carcinoma were exophytic appearance and clinical hyperkeratosis, with 43-fold and 6-fold higher probability respectively. White clods and ulceration in dermoscopy presented a 6-fold and 4-fold increased risk for squamous cell carcinoma respectively. CONCLUSIONS A scaly lesion with exophytic growth, dermatoscopically displaying white clods, ulceration and linear and hairpin vessels is very likely a squamous cell carcinoma of the lip.
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Affiliation(s)
- A Lallas
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Martínez
- Department of Dermatology, School of Medicine, University of Chile, Santiago, Chile
| | - M Arceu
- Department of Dermatology, School of Medicine, University of Chile, Santiago, Chile
| | - A Kyrgidis
- Department of Oral & Maxillofacial Surgery, Aristotle University of Thessaloniki, General Hospital of Thessaloniki "George Papanikolaou", Thessaloniki, Greece
| | - K Liopyris
- First Department of Dermatology, Andreas Syggros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - G Brancaccio
- Dermatology Department, University of Campania, Naples, Italy
| | - C Longo
- Dermatology Department, University of Modena and Reggio Emilia, Modena, Italy.,Centro Oncologico ad Alta Tecnologia Diagnostica, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - E Errichetti
- Institute of Dermatology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - D Sgouros
- Second Department of Dermatology, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - C Papageorgiou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - C Fotiadou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S Siskou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S M Manoli
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Sotiriou
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Ioannides
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Katoulis
- Second Department of Dermatology, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - E Lazaridou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - G Argenziano
- Dermatology Department, University of Campania, Naples, Italy
| | - Z Apalla
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Jha AK, Sonthalia S, Sławińska M, Lallas A, Vinay K, Sobjanek M, Kamińska-Winciorek G, Zeeshan M, Errichetti E. Mucoscopy of lip squamous cell carcinoma and correlation with skin phototype and histological differentiation: a multicentric retrospective observational study by the International Dermoscopy Society. Int J Dermatol 2020; 60:489-496. [PMID: 33141442 DOI: 10.1111/ijd.15291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/24/2020] [Accepted: 10/06/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is a scarcity of published data on the dermoscopic morphology of lip squamous cell carcinoma (SCC) and its variability according to the histological differentiation degree and patient's ethnicity as per skin phototype. OBJECTIVES To evaluate the dermoscopic features of SCC of the lips and identify possible dermoscopic clues that may aid in differentiation between well-differentiated, moderately-differentiated, and poorly-differentiated lesions, as well as between "fair" skin (Fitzpatrick skin phototypes I-III) and "dark" skin (Fitzpatrick skin phototypes IV-VI). METHODS The clinical profile and dermoscopic images of patients of any age and either gender with histologically confirmed lip SCC collated from seven dermatological centers were retrospectively evaluated for dermoscopic clues as per certain predefined criteria. RESULTS A total of 60 lesions from 60 patients were included in the analysis. Histologically, well, moderate, and poordifferentiation were seen in 24 (40%), 14 (23.3%), and 22 (36.7%) of the lesions, respectively. Other than the presence of brown-to-gray dots/globules, which was exclusively seen in cases with dark phototypes (19.4% P = 0.035), no other dermoscopic feature was statistically significant in differentiating between the two skin types. Some dermoscopic findings were observed specifically with statistical significance: perivascular white halos (P = 0.049) and whitish-yellow background in well-differentiated lesions (P = 0.003); pink background in moderately-differentiated lesions (P = 0.003); and red background with dense vascularity in poorly-differentiated lesions (P < 0.001). CONCLUSIONS The presence of vessels, scale/crust, and keratinization-associated white structures were the most common dermoscopic clues in lip SCC.
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Affiliation(s)
- Abhijeet Kumar Jha
- Department of Skin and VD, Patna Medical College & Hospital, Patna, India
| | | | - Martyna Sławińska
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - Aimilios Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Michał Sobjanek
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, Gdańsk, Poland
| | - Grazyna Kamińska-Winciorek
- The Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska- Curie National ResearchInstitute of Oncology (MSCNRIO), Gliwice Branch, Poland
| | - Md Zeeshan
- Department of Skin and VD, Patna Medical College & Hospital, Patna, India
| | - Enzo Errichetti
- Institute of Dermatology, "Santa Maria della Misericordia University Hospital, Udine, Italy
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