Metastatic lower lip cancer

Abstract

Introduction. Squamous cell carcinoma of the lower lip is the most common malignancy of the oral cavity and the sixth most common cancer in the world. The 5-year survival rate for patients with early stages is 80-90% and for those with advanced stages it is reduced to about 50%. Cryotherapy is the alternative method of treating superficial forms of lower lip cancer in stage I and II. The literature still remains controversial regarding the need for lymphadenectomy of the submandibular and submental regions, even in the absence of lymphatic invasions (NO). Late metastases of lower lip cancer are found in 0-15% of cases for T1 and 32% for T2. Case presentation. Patient, N. 66 years was diagnosed with cancer of the lower lip right angle T1N0M0 st. The patient underwent cryosurgical treatment with stabilization of the process for 2 years, at repeated treatment the patient has a metastatic tumor in the submandibular region on the right mobile, painless without affecting the skin 1.7 x 2.2 cm in diameter. He was hospitalized at the Oncological Institute of the Republic of Moldova, section "Head and neck tumors" where the diagnosis of lower lip cancer is established, condition after tumor cryodestruction, progression of the process with metastatic submandibular lymphadenopathy on the right. It was planned that the patient underwent surgical treatment in the volume of "Level I Submandibular Cervical Lymphadenectomy on the Vanach-type Straight". The postoperative period passed satisfactorily, the wound regenerated first, the sutures stolen on the 7th postoperative day. For two years, at the prophylactic examinations, the patient does not present data of local and metastatic loco-regional recurrence. Discussion. Regional recurrence in the neck was the most common site of recurrence. Our results did support the belief that early surgical salvage had a reasonable chance of cure with 5-year disease free survival. Conclusion. The lower lip cancer is a destructive local cancer with a major metastatic potential. This case demonstrates that, in the initial stages, lower lip cancer according to the physical method of cryodestruction without data of locoregional recurrence, has a major potential for regional cervical metastases.