Lip Cancer: Symptoms, Diagnosis, And Treatment

Lip Cancer: Symptoms, Diagnosis, And Treatment

Write short note on Ca lip.

Answer. Calip: Carcinoma of lip.

Vermilion border of lip and mucosa is the main site of carcinoma of lip.

It is common in the western elderly, white people, specially those people exposed to sunlight.

The lesions known as countryman’s lip because it occurs commonly in agriculturists.

“Causes Of Lip Cancer”

Carcinoma of lip Etiology

• Excessive use of tobacco
• Leukoplakia and syphilis
• Placing khaini between lower lip and gum
• Heavy consumption of alcohol
• Radiation to the lip.

Carcinoma of lip Clinical Features

• Elderly males are affected in 90% of cases.
• Non-healing ulcer or growth is a common presentation.
• Lesion appears in the form of white plaque of non-healing ulcers.
• Edges are everted and indurated, this is characteristic of carcinoma.
• Ulcer contain slough in flor.
• Bleeding may occur from ulcer.
• Pain and paresthesia may occur.
• Lesion may get fied to the subcutaneous structure of lip.
• Ulcer spreads and destroys the tissue of lip and chin.
• Sub-mental and submandibular lymph nodes are involved,lymph node becomes hard and may be filed.

“Symptoms Of Lip Cancer”

Carcinoma of lip Differential Diagnosis

• Leukoplakia
• Syphilitic chancre
• Keratocanthoma
• Ectopic salivary gland tumor
• Pyogenic granuloma.

Carcinoma of lip Treatment

• If lesion is less than 2 cm, then curative radiotherapy,either brachytherapy or external beam radiotherapy. It gives a good cure.
• If tumor is more than 2 cm, wide excision is done.
  Excision of lower lip up to one-third can be sutured primarily, in layers keeping vermilion border in proper apposition without causing any microstomia.
• Excision of more than one-third of the lip requires reconstruction using diffrent flps.

“Risk Factors For Developing Lip Cancer”

Carcinoma of lip Methods

• Abbe-Estlander‘s rotation flap used for either upper or lower lip lesions located at the angle based on labial artery.
  Here base at a later stage need not be disconnected unlike in Abbe lip.
• Fries modifid bernard facial flip: Reconstruction using lateral facial flaps. It is used when defect is more than half of lip and midline.
• Gillies fan flap: It is a cheek flap usually bilateral but can be unilateral. Incision is full thickness around commissure
  extending into nasolabial fold and upper lip up to upper lip vermilion border. Flap which is based on labial vessels advanced towards the defect. Vermilion is reconstructed with tongue mucosal flp which is divided in 3 weeks.
• Karapandzic flp: It is the modifid version of Gillie’s flp used for lower lip defect with less angulations towards
  upper lip. Reverse Karapandzic flp is used for upper lip.
• Microvascular flps.
• Nasolabial flp: It is used when defect is more than half of lip laterally or defect is in the flor of mouth.
• Cheek flap.

“Understanding The Causes Of Lip Cancer”

• Free radial artery flap
• Abbe flap: It is used for upper or lower lip lesions at the middle or the site other than angle based on labial artery.
  Here at the later second stage base of the flp should be released once as flps takes up.
• ‘W’ flp plasty: It is done for lower lip middle tumor which is less than one-third of the lip.
• Johansen stepladder procedure is used for extensive carcinoma of lower lip.
• Other regular flps like forehead flp, deltopectoral flp can also be used.
• Lymph nodes are dealt with by radical neck dissection on one side and functional block or supraomohyoid block dissection on other side.
  For central tumor N0 disease,bilateral elective (prophylactic) supraomohyoid dissection is done.
  For lateral tumour N0 disease, elective ipsilateral supraomohyoid dissection is done.
• Postoperative radiotherapy is given if the tumor is large or if lymph nodes are involved.
• When mandible is involved, segmental resection is done.