IPLab:Lab 7:Lip SCC
This 63-year-old white male had recurrent thickening and scaling of the lower lip for two years. In recent months, it had undergone ulceration and progressive enlargement. The lesion was excised by a wedge resection.
The specimen was triangular in shape; the upper part was covered by mucosa and the lower part by skin. At the junction of the mucosa and skin there was a 2 x 1.4 cm oval shaped superficial lesion which was flat, firm, and had raised borders. The base was orange.
Squamous cell carcinomas make up at least 95% of cancers of the oral cavity (including the tongue). Other tumors include adenocarcinomas (of mucous gland origin), melanomas, various carcinomas, and other rarities. The incidence of oral squamous cell cancers in the United States is about 4% for men and 2% for women.
Tobacco and alcohol. Nondrinking smokers have a 2- to 4-fold greater risk of developing these cancers than matched control subjects, which increases to 6- to 15-fold with both drinking and smoking. The risk of cancer is quantitatively associated with the amount of smoking and of alcohol consumption. Chewing tobacco and buccal pouches are the highest risk.
The prognosis is best with lip lesions--the 5-year recurrence-free rate approximating 90%--and poorest with tumors in the floor of the mouth and at the base of the tongue--yielding only 20 to 30% 5-year recurrence-free rates. All squamous cell carcinomas of the oral cavity take months to years to progress from carcinoma in situ (after being preceded by leukoplakia) to invasive cancer.
- eMedicine Medical Library: Head and Neck Cutaneous Squamous Cell Carcinoma
- Merck Manual: Overview of Skin Cancer
- Merck Manual: Squamous Cell Carcinoma
- Guenthner ST, Hurwitz RM, Buckel LJ, Gray HR. Cutaneous squamous cell carcinomas consistently show histologic evidence of in situ changes: a clinicopathologic correlation. J Am Acad Dermatol 1999 Sep;41(3 Pt 1):443-8.
- Ling S, Hu Z, Yang Z, Yang F, Li Y, Lin P, Chen K, Dong L, Cao L, Tao Y, Hao L, Chen Q, Gong Q, Wu D, Li W, Zhao W, Tian X, Hao C,Hungate EA, Catenacci DV, Hudson RR, Li WH, Lu X, Wu CI. Extremely high genetic diversity in a single tumor points to prevalence of non-Darwinian cell evolution.. Proc Natl Acad Sci U S A 2015 Nov 24;112(47):E6496-505.
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The normal fibrinogen level is 184 to 412 mg/dL.