CARCINOMA LIP

• Carcinoma lip is more common in western countries.

ETIOLOGY-

• UV radiation (in farmers, due to sun exposure as Countryman’s lips leads to carcinoma lip).
• Leukoplakia
• Genetic factor
• Khaini chewers

CLINICAL FEATURES-

• Seen in elderly person.
• Most common on vermillion border of lower lip.
• Non healing ulcer have everted margins, indurated base and bleed on touching.
• Exophytic crusted lesion.
• Mobility present.
• Lymph nodes metastases to submental or submandibular nodes.

HISTOLOGY

• Carcinoma lip are usually always well differentiated.

INVESTIGATIONS-

• Biopsy should be taken from the margin of the lesion.
• FNAC of enlarged cervical lymph nodes.
• OPG of jaw to assess involvement of the jaw
• CT scan is better than radiograph and detects cortical bone destruction.
• MRI is the investigations of choice for oral cancer.
• Ultrasound is useful in detecting liver metastasis in guiding FNAC.

TREATMENT-

1. Surgery-
2. T1 and T2 lesion excised followed by suturing (V- excision)
3. Removal of 1/3^rd of lip-

• If 1/3rd or less than 1/3rd lip is involved- V- shaped or W- shaped 
• If more than 1/3rd lip is involved- Abbe flap, Estlander’s flap (Cross lip flap)

1. T3 & T4 lesion

• Excision of entire lip needed followed by PMMC flap reconstruction

1. Radiotherapy- indicated in all stages of carcinoma lip.

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