Tuesday, April 23, 2013

HEAD NECK 10 Malignant tumors Lip


5. MALIGNANT TUMOURS
Sqaumous cell carcinoma make up the majority of all carcinomas of
the oral cavity, highly differentiated tumours occur less  often,
anaplastic lesions are rare.
Adenocarcinomas are met with and originate in the minor  salivary
glands.
5.1 LIP
Squamous cell carcinomas are the common malignant tumours of  the
lip  and  represent  nearly 15% of all  head  and  neck  cancers.

Basal cell carcinomas are less frequent.
ETIOLOGY
Important relationship exists between tumours of lip and exposure
to sunlight.
*  Complexion plays a role, susceptible are the fair skinned  and
   ligh haired.
*  Dark haired and dark skinned individuals are resistant.
*  Tobacco   chewing  and pipe smoking have been suspected  as  a
   cause of lip cancer.
*  It  is possible that the stems of wood and clay pipes soak  up
   tobacco tar directly and cause the disorder.





PATHOLOGY

*  The  tumour is a squamous carcinoma and occurs most  often  on
   the lower lip.

*  It is low grade well diffentiated lesion

CLINICAL

*  Lower lip in the site in 70%

*  Though slow growing, some patients may present when the lesion
   has reached a large size, destroying the entire lip.

*  There may be cervical lymphnodes, usually submental nodes.

*  An  ulcer of the lip which fails to heal should  be  suspected
   early.

TREATMENT

*  Treatment  for  small lesions is local  excision  under  local
   anaesthesia.

*  Radiation can also achieve good results in lesion below 2  cm.
   and can be given as outpatient therapy.

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