RESUMEN
The lips have important functional and esthetic facial features and the lips are used for relatively simple tasks, such as retaining oral contents, as well as for complex functions such as mastication, speech and expressing emotion. Therefore, it is esthetically and functionally critical to maintain the normal position and contour of the lips during reconstructive surgery. However, the freely movable nature of the vermilion and the cutaneous lip makes this area highly susceptible to distortion. We report here on a case of squamous cell carcinoma on the lower lip and the extensive surgical defect that resulted from total vermilionectomy and wedge resection of the lip was repaired with the tongue flap.
Asunto(s)
Humanos , Carcinoma de Células Escamosas , Labio , Masticación , LenguaRESUMEN
Purpose: Ultraviolet radiation is the main etiological agent associated with the development of actinic cheilitis, a premalignant irreversible disease that frequently affects the vermilion border of the lower lip. This paper aimed to describe the case of a patient with actinic cheilitis and treated with scalpel vermilionectomy. Case Description: A male, Caucasian, 66 year-old subject sought dental treatment complaining of "wounds on the lip that not heal" for approximately 15 years. The patient reported that he had worked in farms since the age of 5 year-old and was a frequent user of alcohol and tobacco. Atrophic and erosive areas associated with many ulcers covered with eschars were observed throughout the length of the lip. Based on the patient history and clinical exam, scalpel vermilionectomy was proposed. The histopathological analysis revealed a superficially invasive squamous cell carcinoma with free borders. The patient was monitored for two years with no relapse. Conclusion: Scapel vermilionectomy was chose to treat this case due to its low cost, relatively short time for repair, and possibility of histopathological analysis of the removed tissue.
Objetivo: A radiação ultravioleta é o principal agente etiológico associado ao desenvolvimento da queilite actínica, uma lesão pré-maligna que afeta o lábio inferior. Este trabalho descreveu o caso clínico de um paciente que apresentava várias ulcerações recobertas por crosta no lábio inferior e foi tratado pela técnica da vermelhectomia. Descrição do caso: Um sujeito do sexo masculino, Caucasiano, de 66 anos de idade, procurou tratamento odontológico com queixa de "feridas no lábio que não cicatrizavam" por 15 anos. O paciente relatou que tinha trabalhado em fazendas desde os 5 anos de idade e fazia uso frequente de tabaco e álcool. Áreas erosivas e atróficas associadas a múltiplas úlceras cobertas com escaras foram observadas em todo o lábio. Com base na história do paciente e exame clínico, foi proposto tratamento por vermelhectomia. O diagnóstico histopatológico foi de carcinoma espinocelular superficialmente invasivo, com margens livres, e o paciente foi acompanhado por um período de 2 anos sem recidiva. Conclusão: A técnica da vermelhectomia foi a escolha preferencial de tratamento por ser de baixo custo, ter um tempo cicatricial relativamente curto e, especialmente, permitir que o tecido removido possa ser examinado histopatologicamente.
Asunto(s)
Humanos , Masculino , Anciano , Trastornos por Fotosensibilidad , Queilitis/terapia , Rayos UltravioletaRESUMEN
A sixity-three years old male admitted our department of dermatology showing generallized scaly, fissured, and swollen lower lip, we could diagnose it actinic cheilitis by the finding of skin biopsy specimen. And so we recomrnended him vermilioneciomy for the prophylaxis of squamous cell carcinoma, but he refused. After 2 months, above Iesion was changed a rapidly proliferating protruded mass in the centcr of the lower lip, which was diagnosed squamous cell carcinoma. For the treatment of squamous cell carcinoma and remained actinic cheilitis, we performed V-shaped excision of tumor mass and verrniliomy. After 5 months follow-up evaluation, the patient appeared excellent results without recurrence.