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Cancer of the lip
Last reviewed: 07.07.2025
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[ Symptoms
Lip cancer manifests itself in several forms: exophytic, ulcerative and ulcerative-infiltrative. The course of early forms can be largely determined by previous precancerous processes.
Exophytic lip cancer can have different manifestations. In some cases, the process begins with the appearance of a papilloma, its surface becomes ulcerated, an infiltrate appears along the edge, which gradually increases. Then an ulcer with dense ridge-like edges forms at this site. The warty variety of exophytic lip cancer manifests itself in the form of small, bumpy formations that merge with each other and resemble cauliflower in appearance. Later, infiltration and ulceration of the surrounding tissues join in.
In exophytic forms, which proceed more malignantly, the process can begin with cracks, a round ulcer, the bottom of which gradually deepens, becomes fine-grained, the edges rise in a ridge, the tumor takes on the appearance of an ulcerative form. A dense infiltrate appears at the base of the ulcer. The ulcerative form turns into an ulcerative-infiltrative one.
With further spread, the tumor may affect the corner of the mouth, as well as the upper lip.
Diagnostics
Diagnosis is based on the clinical picture and the results of a morphological examination of the tumor (after puncture or biopsy).
Most malignant tumors are squamous cell carcinoma (according to various authors, 96-98%). More common is squamous cell keratinizing cancer of the lip, which is characterized by a relatively slow course. Regional metastases develop, as a rule, late. The most aggressive in terms of spread and development of metastases is poorly differentiated cancer of the lower lip.
The above clinical signs allow to make a correct diagnosis, determine the treatment tactics and prognosis of the disease. In the initial stages, differential diagnostics are carried out with precancerous processes: wart precancer, limited hyperkeratosis, Manganotti cheilitis, keratoacanthoma, etc. Ulcerative and ulcerative-infiltrative lip cancer should be differentiated from tuberculosis and syphilitic lesions.
In difficult cases, it is necessary to take scrapings from the surface of the tumor or perform a puncture with subsequent cytological and histological examination. If the results are negative, a biopsy is indicated, preferably in the institution where further treatment will be carried out.
Lip cancer most often develops in people working outdoors (agricultural workers, fishermen, etc.). This is explained by the effect of various atmospheric factors (insolation, wind, temperature changes, etc.) on the skin of the face and the red border. Chronic trauma and smoking are also important. As a rule, malignant tumors are preceded by various precancerous processes. The most common method of treating stage I-III lip cancer is currently radiation therapy or surgery. In the initial stages, such tactics ensure the absence of relapses for 5 years or more in 95-100% of patients. In widespread forms, as well as radioresistant types of tumors, they resort to combined treatment. At the first stage, a preoperative course of radiation therapy is carried out, at the second - radical surgery with plastic closure using one of the existing methods (Bruns, Dieffenbach, Blokhin, etc.). In recent years, cryodestruction with liquid nitrogen has been widely used, especially in limited processes.
Lip cancer has a different prognosis. It depends on many reasons: the stage of the tumor process, the form of tumor growth, the timeliness and correctness of treatment. In general, compared to malignant tumors of other localizations, this form proceeds favorably. After treatment, working capacity is usually not impaired.