Upper lip malignant neoplasms. A study of 59 cases

Tumors of the labial mucosa: a retrospective study of 1045 biopsies

BACKGROUND

To investigate the relative frequency of localized mucosal swellings of the upper and lower labial mucosa, the clinical-pathological diagnosis agreement and whether patient's age and gender and tumor's site and size may raise the suspicion of neoplasm.

MATERIAL AND METHODS

Retrospective analysis was performed on upper or lower labial mucosal tumors, histopathologically diagnosed between 2009-2018. The diagnostic categories developmental/reactive tumors, benign and malignant neoplasms were associated with patient's age and gender and tumor's site and size; clinical-pathological diagnosis agreement was, also, evaluated.

RESULTS

Overall, 1000 (95.7%) developmental/reactive tumors, 35 (3.3%) benign and 10 (1%) malignant neoplasms were found. Upper/lower lip tumor ratio was 0.14:1. The diagnostic category was significantly associated with age (p<0.0001), site (p<0.0001) and diameter (p<0.0001). Age ≥60 years, tumor's location on the upper lip and diameter >1cm were independent predictors for neoplasms. Patients presenting 2 or 3 of these variables were 20.2 times (p < 0.0001) or 33.6 times (p < 0.0001), respectively, more likely to have a neoplasm. Complete/partial agreement between clinical and pathological diagnosis was seen in 96.3% of the cases.

CONCLUSIONS

Most lip tumors involve the lower lip and are reactive, but upper lip tumors measuring >1cm in patients≥60 years have significantly higher probability to be neoplasms.

Adenoid squamous cell carcinoma of upper lip, a rare variant of squamous cell carcinoma: A case report

Adenoid squamous cell carcinoma (ASCC) is a variant of squamous cell carcinoma. As this variant is rare it is difficult to distinguish it from other variants of squamous cell carcinoma. It commonly originates in the head and neck region as these parts are highly exposed to the sunlight. There are very few cases reported in the literature. Here we report a case in a 30-year-old male who reported with a nodular lesion over the upper lip with no unusual signs, which was confirmed as adenoid squamous cell carcinoma after various histopathological tests.

Application of vermillion myocutaneous flap in restoration after lip cancer resection

To investigate the application of the vermillion myocutaneous flap in restoration after lip cancer resection. From July 2012 to December 2019, six patients with lip cancer admitted in our department were included in this study. Total defect of the whole layer of the lip, accounted for 1/3 to 1/2 of the total length of the lip after tumor resection, were repaired by vermillion myocutaneous flap. For the case defect presenting >1/2 of the total length of the lip, a local rotational flap was designed with vermillion myocutaneous flap compound to repair the defect. At present, the patients were followed up for 6 months to 7 years. There was no tumor recurrence. The aesthetic effects and function of lip after operation were ideal, with satisfactory outcomes. Vermillion myocutaneous flap with the labial artery as the axis was an effective method to restore the anatomical structure and function of the lip. In the presence of a defect area of larger than 1/2 of the length of the whole lip, local skin flap can be used for simultaneous repair in order to achieve satisfactory outcome.

Management of and risk factors for regional recurrence in upper lip squamous cell carcinoma

Our goal was to evaluate the risk factors for regional recurrence in upper lip squamous cell carcinoma (SCC).A total of 109 patients with upper lip SCC were retrospectively enrolled. Clinical and pathologic information was collected and analyzed.Fifteen (13.8%) patients had a regional metastasis, 2 patients had parotid node metastasis, and no local or distant metastasis was noted. There was neck level I node metastasis in 15 (100%) patients. In multivariate analysis, invasion depth and degree of differentiation were significantly associated with regional metastasis. The 5- and 10-year disease-specific survival rate was 95.4% and 80.1%, respectively.Invasion depth and degree of differentiation have reliable value for predicting regional metastasis.

Resection of upper lip adenoid cystic carcinoma and reconstruction with reverse Yu flap: Report of three cases and a literature review

The present study aimed to describe the techniques that were used, and the results obtained, with the reverse Yu flap to reconstruct medium-sized upper lip defects following resection for adenoid cystic carcinoma (ACC). Data concerning the clinical and pathological characteristics of tumours, the size and location of the defects, surgical resection and the reconstructive procedure used were evaluated in three patients, as well as postoperative complications and outcomes. In all cases, a complete surgical removal of ACC was achieved with clear margins of at least 1 cm. Histopathological features revealed two cases with a predominant solid growth pattern, and one case of cribriform. Following tumour excision, the average size of the upper lip defect was 35.7×30 mm. The reverse Yu flap was raised simultaneously with tumour resection in all cases. No flap failed, and both excellent aesthetic and functional results were obtained. All the patients had a satisfactory oral competence, without microstomia, after a median of 20 months follow-up (range, 12-30 months). Adjuvant radiation therapy was not necessary in any case. On the basis of the present case study and literature review, reverse Yu flap is revealed to be a simple and reliable technique for the reconstruction of defects ranging from one-third to two-thirds of the total upper lip length, involving the commissure, nasolabial fold and philtrum, with minimal donor morbidity and a good functional and aesthetic outcome. This flap appears to be a valid surgical option for reconstruction of medium-sized upper lip defects, which may be considered following radical excision of ACC.

The pattern of lip cancer occurrence over the 1990-2011 period in public hospitals in Madrid, Spain

BACKGROUND

Some regions of Spain along with Canada and Australia have the highest rates of lip cancer in the world. The objective of this study was to examine the trends in the pattern of occurrence of lip cancer in Madrid, Spain.

METHODS

Data were extracted from the Central Tumour Registry of Madrid, between 1990 and 2011. Variables examined were age, sex, topographic and morphological location and tumour histology. Two consecutive periods, 1990-2001 and 2002-2011, were studied by descriptive and analytical methods, and the data from the two periods were statistically compared.

RESULTS

A total of 881 cases were registered during the period 1990-2011. Comparing data between the two periods (1990-2001 and 2002-2011), subtle variations in age, histology and location were noted. Gender ratios remained constant. The mean age increased from 66.3 to 69.7 years (P < 0.05). In the second period, the histological distribution showed an increase in frequency of basal cell carcinoma, from 2.1% to 4.7%, while the frequency of squamous cell carcinomas remained constant. Basal cell carcinoma no longer predominantly occurred in women, decreasing from 80% to 21.1% (P < 0.001). The distribution by gender of squamous cell carcinoma had become more equal due an increase in its frequency in women (P < 0.001). Frequency of tumours on lip mucosa and commissure had increased between the two periods (P < 0.004).

CONCLUSIONS

The pattern of lip cancer reported to Public Hospitals of Madrid is changing: declining rates are noted since 2001-02. However, it is necessary to monitor these data to confirm the observed trends in future years.

Intra- and extraoral prostheses retained by zygoma implants following resection of the upper lip and nose

Upper lip cancers are infrequent lesions, being aggressive unless diagnosed and treated early. After the surgical resection, maxillofacial defects require special care in rehabilitation. This article describes the maxillofacial rehabilitation of an edentulous patient diagnosed with upper lip squamous cell carcinoma. The treatment consisted of a large amount of upper lip and nose tissue resection, followed by chemoradiotherapy. After the first surgical healing, zygoma implants were inserted in a two-step procedure. The maxillary and nasal prostheses were installed and fixed by a titanium framework. After 6 years follow-up, no recurrences were observed, and the patient did not develop metastases. Tissues around implants were in good health, and the prostheses remained well-fitted. The use of implant-retained prostheses improved the quality of life, and the patient was extremely satisfied with the final result. The implant-retained prostheses are well accepted by the patient, improving comfort and safety during function while recovering her esthetic apperance.

Significant differences in nonmelanoma skin cancers of the upper and lower lip

BACKGROUND

Squamous cell carcinomas (SCCs) generally have been reported to be more prevalent on the lips than basal cell carcinomas (BCCs), but in our experience, BCCs of the lips are common, particularly in women.

OBJECTIVES

To determine the tumor characteristics of lip SCCs and BCCs, including tumor type, anatomic location, and size; and to identify the relationship between patient characteristics, including age and sex, and lip tumor characteristics.

METHODS AND MATERIALS

Retrospective review of all BCCs and SCCs located on the lip treated between January 1995 and October 2010.

RESULTS

Of 470 lip nonmelanoma skin cancers (NMSCs) identified, 71.4% were BCCs, and 28.6% were SCCs. Lower lip tumors were predominantly SCCs (79.8%, p < .01), whereas upper lip tumors were predominantly BCCs (85.7%, p < .01). Patients with lower lip tumors were significantly older (68.8 vs. 64.7, p = .02) and were largely male (70.8%, p < .01). Patients with SCCs were mostly male (62.2%, p = .02), whereas those with BCCs were predominantly female (68.8%, p < .01). Subgroup analysis showed that upper lip tumors were 98.1% cutaneous or more than 50% cutaneous, whereas 56.3% of lower lip tumors were mucosal or more than 50% mucosal; 87.1% of mucosal tumors were SCCs, whereas 83.6% of cutaneous tumors were BCCs (p < .01). Seventy-one percent of patients with mucosal tumors were men, whereas 67% of patients with cutaneous only tumors were women (p < .01).

CONCLUSION

These data provide evidence of significant differences in patient and tumor characteristics between NMSCs of the upper and lower lips.