J Korean Assoc Oral Maxillofac Surg.  2023 Oct;49(5):292-296. 10.5125/jkaoms.2023.49.5.292.

Squamous cell carcinoma of lower lip: the results of wide V-shaped resection

• Youn SB
• Myoung H
• Kwon IJ

• KMID: 2547574
• DOI: http://doi.org/10.5125/jkaoms.2023.49.5.292

Abstract

Generally, if the size of a lip cancer defect exceeds 30% of the lower lip, a local flap or free flap is recommended. However, defects up to 50% of the lower lip in size have been reconstructed successfully by primary closure without a local flap or free flap. In one case, an 80-year-old male farmer who had smoked for more than 50 years presented with squamous cell carcinoma of the lower lip and underwent mass resection and supraomohyoid neck dissection. The defect accounted for almost 2/3 of the lower lip and was repaired by primary closure with V-shaped resection. Biopsy results confirmed pT2N0cM0 stage II disease with clear margins. In another case, a 68-year-old male also presented with squamous cell carcinoma of the lower lip and underwent mass resection. The defect accounted for about half the size of the lower lip but was repaired by primary closure with V-shaped resection. Both patients experienced no discomfort while eating or speaking and were satisfied with the cosmetic and functional outcomes with no evidence of recurrence. Thus, direct closure can be considered even in large lower lip cancers.

Keyword

Lip neoplasm; Squamous cell carcinoma; Direct closure; Primary closure

Figure

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  Fig. 1 Preoperative clinical photo and enhanced computed tomography (CT) view. A tumor mass approximately 2.5 cm in diameter crosses the wet-dry border of the oral cavity. A, B. Clinical photos. C. CT axial view. D. Magnetic resonance imaging axial view.

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  Fig. 2 Intraoperative clinical photo. The mass was excised with a safety margin using a V-shaped incision. A, B. Clinical images before operation. C, D. Clinical images after operation.

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  Fig. 3 Clinical photo three days postoperative. The defect was restored with direct closure.

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  Fig. 4 Histopathologic view of the main mass. Keratin pearls can be identified in the histopathologic image (H&E staining, A: ×4, B: ×100).

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  Fig. 5 The H&E stained histopathologic specimen from the incisional biopsy performed on the first visit (A) and the main mass (B) in Case 2. A. At first the lesion was diagnosed as dysplasia due to lack of tumor invasion of the basement membrane. B. The main mass from the surgery was diagnosed as squamous cell carcinoma (H&E staining, A: ×12.5, B: ×12.5).

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  Fig. 6 Preoperative clinical photograph of the lower lip tumor in Case 2.

Reference

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