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Lip Cancer
Last reviewed: 23.04.2024
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[Symptoms
Lip cancer manifests itself in several forms: exophytic, ulcerative and ulcerative infiltrative. The course of early forms can largely be due to previous precancerous processes.
Exophytic lip cancer can have different manifestations. In some cases, the process begins with the appearance of the papilloma, its surface is expressed, an infiltrate appears on the edge, which gradually increases. Then an ulcer with dense, cylindrical edges forms on this site. A wart variety of exophytic lip cancer manifests itself in the form of small tuberous formations that merge with each other and resemble cauliflower in appearance. In the future, infiltration and expression of surrounding tissues are added.
In exophytic forms, which are more malignant, the process can begin with cracks, a round ulcer, the bottom of which gradually deepens, becomes fine-grained, the edges roll up in a cylindrical form, the tumor acquires a form, as in a ulcerative form. At the base of the ulcer appears a dense infiltrate. The ulcerative form becomes ulcerative-infiltrative.
With further spreading, the tumor can hit the corner of the mouth, as well as the upper lip.
Diagnostics
Diagnosis is based on the clinical picture and results of morphological examination of the tumor (after a puncture or biopsy).
Most malignant tumors are squamous cell carcinoma (according to various authors, 96-98%). The squamous keratinizing cancer of the lip is more common, characterized by a relatively slow course. Regional metastases develop, as a rule, late. The most aggressive for the spread and development of metastases is the low-grade cancer of the lower lip.
These clinical signs allow you to put the right diagnosis, determine the tactics of treatment and the prognosis of the disease. In the initial stages, differential diagnosis is performed with precancerous processes: a wart precancer, hyperkeratosis limited, Manganotti cheilititis, keratoacanthoma, etc. Ulcerative and ulcerative infiltrative lip cancer should be differentiated from tuberculosis and syphilitic lesion.
In difficult cases it is necessary to take scrapings from the surface of the tumor or perform a puncture followed by cytological and histological examination. If the results are negative, a biopsy is indicated, preferably in an institution where further treatment will be carried out.
Lip cancer is more common in people working in the open air (agricultural workers, fishermen, etc.). This is due to the impact on the skin of the face and the red border of various atmospheric factors (insolation, wind, temperature changes, etc.). Chronic trauma and smoking are also important. As a rule, various precancerous processes precede malignant tumors. The most common method for treating stage I-III lip cancer is currently radiation therapy or surgical treatment. In the initial stages, such a tactic provides no relapse for 5 years or more in 95-100% of patients. In common forms, as well as radioresistant types of tumors resort to combined treatment. At the first stage, a preoperative course of radiotherapy is performed, on the second stage, a radical surgery with plastic closure according to one of the existing methods (Bruns, Dieffenbach, Blokhin, etc.). In recent years, especially with limited processes, cryodestruction with liquid nitrogen is widely used.
Lip cancer has a different prognosis. It depends on many reasons; stages of the tumor process, tumor growth forms, timeliness and correctness of treatment. In general, this form is favorable in comparison with malignant tumors of other localizations. After treatment, work capacity, as a rule, is not violated.