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Background: Fibrolipoma of the lower lip is an uncommon condition with limited documentation in the literature. This paper provides updated insights into oral and maxillofacial lipomas through a detailed case report and comprehensive literature review, discussing clinical features, pathogenesis, diagnostic approaches, histopathology, and therapeutic strategies., Case Presentation: A 54-year-old female presented with a painless, enlarging mass on the inner aspect of her right lower lip, first noticed 2 years prior. The mass, now the size of a peanut, interfered with her eating and speech. Physical examination revealed a 2.0 × 2.5 × 1.0 cm mass beneath the mucous membrane of the right lower lip. It was firm, well-demarcated, and mobile. Surgical excision was performed, and histopathological analysis confirmed the diagnosis of a lower lip fibrolipoma. The lesion was successfully removed without recurrence., Conclusion: Lipomas in the oral and maxillofacial regions are rare, slow-growing benign tumors, particularly within the lips. Although their diagnosis is straightforward based on clinical presentation, histopathological confirmation is essential. Surgical resection remains the treatment of choice, with excellent prognostic outcomes., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Chondroid syringoma (CS) is a benign, slow-growing mixed tumour that arises from the sweat glands and usually presents in the head and neck area. Histopathological examination is important for proper diagnosis, as CS is often confused with epidermal cysts due to its rare presentation. This article presents a man in his 40s with a right upper lip mass that emerged 6 months prior to presentation. An intraoral surgical excision was performed and the histopathological analysis revealed solid epithelial cells that formed multiple, non-branching ducts lined by cuboidal epithelium. Cystic spaces were filled by heterogeneous eosinophilic material embedded in chondromyxoid stroma. Histopathology identified the lesion as an eccrine-variant CS. The patient recovered well., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Squamous cell carcinoma of the lip (LSCC) and oral cavity can be life-threatening if not diagnosed early. Precancerous lesions like actinic cheilitis (AC), can transform into LSCC. Laminin is a fundamental component for basement membrane (BM) and its integrity may prevent neoplastic invasion. Therefore, laminin immunostaining of BM may be useful in identifying early invasion in actinic cheilitis and thus in the differential diagnosis between AC and invasive LSCC or high-grade epithelial dysplasia (ED)., Materials and Methods: Biopsies from 46 patients with oral lesions were histologically analyzed and immunohistochemically stained for laminin-1., Results: AC was diagnosed in 34 patients and LSCC in 12 patients, including 3 patients with AC and concomitant high-grade ED/in situ carcinoma. Laminin-1 immunostaining revealed intense and linear expression of the BM in AC with low-grade ED. Loss of laminin expression was observed in LSCC. Intracellular laminin expression in parabasal cells was noted in AC with high-grade ED/in situ carcinoma., Conclusion: Laminin immunostaining could be useful in identifying AC cases suspected of early invasion. It could also contribute to the histopathological differential diagnosis between AC with low- and high-grade ED and between AC and invasive LSCC. The findings of this study provide new insights into the mechanism involved in the progression process of AC into LSCC, encouraging preclinical studies that may document the stochastic role of laminin in this process., (© 2022. The Author(s).)

Basal cell carcinoma and squamous cell carcinoma are the two most common types of carcinomas, affecting a total of 5.4 million people each year in the United States. Sun-exposed areas, especially the face and nose, are most affected given the strong association between these carcinomas and ultraviolet radiation. Less research has been done surrounding carcinomas of the lip, despite the significant aesthetic and functional importance of this area. Although lip carcinomas tend to follow a classic, unique distribution pattern that favors basal cell carcinoma on the upper lip and squamous cell carcinoma on the lower lip, more cases of lower lip basal cell carcinoma are being reported, warranting further educational awareness to differentiate carcinomas of the lower lip. In this article, we provide an updated overview of the risk factors, presentations, differential diagnoses, metastatic risks, evaluation, management guidelines, and outcomes of lower lip carcinoma. Of note, recent advances in imaging modalities are beginning to show promise as a non-invasive, affordable, and rapid way to detect and stage tumors. We conclude that increased clinical awareness and investigation of lower lip carcinoma is needed to improve early intervention, as a delayed diagnosis can rapidly alter the management and outcomes of lip carcinomas., (© 2022. This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.)

Actinic cheilitis (AC) and lower lip squamous cell carcinoma (LLSCC) exhibit epithelial alterations mainly associated with chronic ultraviolet ray exposure. Currently, it is impossible to predict which AC cases will progress to LLSCC; thus, biomolecular markers have been studied. The aim of this study was to evaluate the immunoexpression of IMP-3 and KI-67 in AC and LLSCC. Forty AC and 40 LLSCC cases were submitted to peroxidase method and quantitatively analyzed, using the following scores: 0 (0% positive cells), + 1(≤ 30%), + 2 (> 30% to ≤ 60%), and + 3 (> 60%). Results were submitted to non-parametric Mann-Whitney (U) test. A p value < 0.05 was considered to indicate statistical significance. IMP-3 immunoexpression was observed in 26 AC cases, with predominance of the score 1 (35% of cases). This protein was also positive in 22 LLSCC cases, with predominance of the score 3 (37.5% of cases). Immunoexpression of KI-67 was observed in all studied cases, with predominance of the score 2 (70% of AC cases and 57.5% LLSCC cases). The association between IMP-3 and Ki-67 immunoexpression, AC dysplastic severity and LLSCC tumoral grade revealed no significant differences. The present results demonstrate that IMP-3 and Ki-67 immunoexpression are frequent in AC and in LLSCC. Moreover, these proteins could be involved in lower lip carcinogenesis process., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Actinic cheilitis is a potentially malignant lesion most commonly found in the lower lip of individuals with chronic exposure to ultraviolet radiation. The aim of this study was to develop and to test a clinical index that can be used to assess the severity of actinic cheilitis., Material and Methods: The clinical index of actinic cheilitis was applied to 36 patients. An incisional biopsy was obtained to grade oral epithelial dysplasias following the World Health Organization (WHO) and binary systems, and to evaluate their association with clinical characteristics by Fisher's exact test (P<0.05). The accuracy of the index was evaluated based on sensitivity, specificity, positive and negative predictive values, and receiver operating curve., Results: The blurring between the border of the lip and the skin was significantly associated with cases without dysplasia/mild epithelial dysplasia (P=0.041) and with low risk of malignancy (P=0.005). Ulcers and crusts were significantly associated with moderate/severe epithelial dysplasia (P=0.002 and P=0.012, respectively) and high risk of malignancy (P=0.005 and P=0.045, respectively). Erosion showed a significant association only with high-risk cases of malignancy (P=0.024). The cut-off values of the diagnostic test showing the best performance were 10 for the WHO grading system and 11 for the binary system., Conclusions: The index cut-offs with the highest accuracy were considered indicators for a biopsy. Erosion, ulceration and crusts were associated with more severe oral epithelial dysplasias.

A 10-month-old girl presented with a 4-month history of a rapidly growing lesion on the lower lip. Initial assessment and Doppler ultrasound supported a diagnosis of pyogenic granuloma. However, emergent biopsy revealed an embryonal rhabdomyosarcoma, a highly malignant tumor commonly associated with cancer-susceptible syndromes including neurofibromatosis type 1 (NF1). Despite having no apparent clinical features of NF1 at initial presentation, she was later found to have multiple café-au-lait spots and a subsequent diagnosis of NF1 was made., (© 2022 Wiley Periodicals LLC.)

Hidradenoma are rare benign tumors with eccrine or apocrine differentiation that most often presents as a small, firm, solitary dermal nodule. At times, hidradenoma shows striking cytologic and histologic similarity to other neoplasms, including its malignant counterpart, hidradenocarcinoma. We present the first reported case of benign hidradenoma of the lower lip. The case illustrates important diagnostic features of hidradenoma and discusses the current understanding of its malignant potential and the appropriate management of such lesions., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Lip, oral cavity, and pharyngeal cancers (LOCP) constitute a group of rare neoplasms with unfavorable prognosis. So far, not much is known about the role of vitamin D and oxidative stress in the pathogenesis of LOCP in the European population. The aim of the study was to determine the concentrations of vitamin D, osteopontin, melatonin, and malondialdehyde (MDA) as markers of oxidative stress and/or inflammation, as well as the activities of antioxidant enzymes in the course of LOCP. The vitamin D, melatonin, and osteopontin concentrations in blood serum, the MDA levels in erythrocytes and blood plasma, and the activities of superoxide dismutase (SOD-1), catalase (CAT), and glutathione peroxidase (GPx) in erythrocytes were measured in blood samples taken from 25 LOCP patients of middle age (YCG), 20 LOCP elderly patients (OCG), and 25 healthy middle-aged volunteers. In both cancer groups, decreases in vitamin D and CAT, as well as increases in osteopontin and blood plasma MDA, were observed. An increase in GPx activity in YCG and a decrease in melatonin level in OCG were found. The results indicate the vitamin D deficiency and disturbed oxidant-antioxidant homeostasis in LOCP patients. Osteopontin seems to be associated with LOCP carcinogenesis and requires further research., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Jarosław Nuszkiewicz et al.)

Although intraductal carcinoma (IDC) of the salivary glands was previously called low-grade cribriform cystadenocarcinoma, it was newly categorized in the 4th version of the World Health Organization classification. We report a case of IDC of the upper lip and examined it immunohistochemically and genetically. The patient was a 48-year-old Japanese female, who noticed a tiny nodule on her left upper lip. Histologically, the tumor cells, which had eosinophilic cytoplasm, exhibited papillary and solid growth patterns, and regions of suspected microinvasion or intraductal spread were also seen at the periphery of the tumor. Small necrotic foci were noted. Immunohistochemically, the tumor cells were diffusely positive for the androgen receptor, CK19, CK5/6, EGFR, and SOX10, whereas they were focally positive for GCDFP-15, S-100 protein, and mammaglobin. The tumor nests were surrounded by alpha-smooth muscle actin-p63-/calponin-/CK14-positive myoepithelial cells. The Ki-67 labeling index was 51.2%. Genetic analysis showed no evidence of the TRIM27-RET or NCOA4-RET fusion gene. We finally diagnosed the tumor as a high-grade mixed intercalated duct/apocrine-type IDC of the upper lip. IDC of the minor salivary glands is exceedingly rare. We discuss diagnostic problems associated with minor salivary gland lesions, and the "basal-like" phenotype of this case., (© 2021. The Japanese Society for Clinical Molecular Morphology.)

Background: Squamous cell carcinoma is the most common form of malignancy of the oral cavity, and is often proceeded by oral potentially malignant disorders (OPMD). Early detection of oral cavity squamous cell carcinoma (oral cancer) can improve survival rates. The current diagnostic standard of surgical biopsy with histology is painful for patients and involves a delay in order to process the tissue and render a histological diagnosis; other diagnostic tests are available that are less invasive and some are able to provide immediate results. This is an update of a Cochrane Review first published in 2015., Objectives: Primary objective: to estimate the diagnostic accuracy of index tests for the detection of oral cancer and OPMD, in people presenting with clinically evident suspicious and innocuous lesions., Secondary Objective: to estimate the relative accuracy of the different index tests., Search Methods: Cochrane Oral Health's Information Specialist searched the following databases: MEDLINE Ovid (1946 to 20 October 2020), and Embase Ovid (1980 to 20 October 2020). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were also searched for ongoing trials to 20 October 2020. No restrictions were placed on the language or date of publication when searching the electronic databases. We conducted citation searches, and screened reference lists of included studies for additional references., Selection Criteria: We selected studies that reported the diagnostic test accuracy of the following index tests when used as an adjunct to conventional oral examination in detecting OPMD or oral cavity squamous cell carcinoma: vital staining (a dye to stain oral mucosa tissues), oral cytology, light-based detection and oral spectroscopy, blood or saliva analysis (which test for the presence of biomarkers in blood or saliva)., Data Collection and Analysis: Two review authors independently screened titles and abstracts for relevance. Eligibility, data extraction and quality assessment were carried out by at least two authors, independently and in duplicate. Studies were assessed for methodological quality using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Meta-analysis was used to combine the results of studies for each index test using the bivariate approach to estimate the expected values of sensitivity and specificity., Main Results: This update included 63 studies (79 datasets) published between 1980 and 2020 evaluating 7942 lesions for the quantitative meta-analysis. These studies evaluated the diagnostic accuracy of conventional oral examination with: vital staining (22 datasets), oral cytology (24 datasets), light-based detection or oral spectroscopy (24 datasets). Nine datasets assessed two combined index tests. There were no eligible diagnostic accuracy studies evaluating blood or salivary sample analysis. Two studies were classed as being at low risk of bias across all domains, and 33 studies were at low concern for applicability across the three domains, where patient selection, the index test, and the reference standard used were generalisable across the population attending secondary care. The summary estimates obtained from the meta-analysis were: - vital staining: sensitivity 0.86 (95% confidence interval (CI) 0.79 to 0.90) specificity 0.68 (95% CI 0.58 to 0.77), 20 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; - oral cytology: sensitivity 0.90 (95% CI 0.82 to 0.94) specificity 0.94 (95% CI 0.88 to 0.97), 20 studies, sensitivity moderate-certainty evidence, specificity moderate-certainty evidence; - light-based: sensitivity 0.87 (95% CI 0.78 to 0.93) specificity 0.50 (95% CI 0.32 to 0.68), 23 studies, sensitivity low-certainty evidence, specificity very low-certainty evidence; and - combined tests: sensitivity 0.78 (95% CI 0.45 to 0.94) specificity 0.71 (95% CI 0.53 to 0.84), 9 studies, sensitivity very low-certainty evidence, specificity very low-certainty evidence., Authors' Conclusions: At present none of the adjunctive tests can be recommended as a replacement for the currently used standard of a surgical biopsy and histological assessment. Given the relatively high values of the summary estimates of sensitivity and specificity for oral cytology, this would appear to offer the most potential. Combined adjunctive tests involving cytology warrant further investigation. Potentially eligible studies of blood and salivary biomarkers were excluded from the review as they were of a case-control design and therefore ineligible. In the absence of substantial improvement in the tests evaluated in this updated review, further research into biomarkers may be warranted., (Copyright © 2021 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.)

Background: To investigate the relative frequency of localized mucosal swellings of the upper and lower labial mucosa, the clinical-pathological diagnosis agreement and whether patient's age and gender and tumor's site and size may raise the suspicion of neoplasm., Material and Methods: Retrospective analysis was performed on upper or lower labial mucosal tumors, histopathologically diagnosed between 2009-2018. The diagnostic categories developmental/reactive tumors, benign and malignant neoplasms were associated with patient's age and gender and tumor's site and size; clinical-pathological diagnosis agreement was, also, evaluated., Results: Overall, 1000 (95.7%) developmental/reactive tumors, 35 (3.3%) benign and 10 (1%) malignant neoplasms were found. Upper/lower lip tumor ratio was 0.14:1. The diagnostic category was significantly associated with age (p<0.0001), site (p<0.0001) and diameter (p<0.0001). Age ≥60 years, tumor's location on the upper lip and diameter >1cm were independent predictors for neoplasms. Patients presenting 2 or 3 of these variables were 20.2 times (p < 0.0001) or 33.6 times (p < 0.0001), respectively, more likely to have a neoplasm. Complete/partial agreement between clinical and pathological diagnosis was seen in 96.3% of the cases., Conclusions: Most lip tumors involve the lower lip and are reactive, but upper lip tumors measuring >1cm in patients≥60 years have significantly higher probability to be neoplasms.

Squamous cell carcinoma (SCC) of the lip typically has a good prognosis when diagnosed at an early stage and treated properly. We present a 65-year-old man with a 3-month history of an ulcerative lesion of the lower lip. On physical examination, he had an ulceration of approximately 5×5 cm in the mucosa of the lower lip, extending through 50% of the lip, and multiple mandibular and neck lymph nodes. The biopsy confirmed SCC of the lip. Surgical treatment was recommended, but the patient was lost to follow-up. The patient eventually returned to the hospital for medical treatment. However, the physical examination, and the images obtained showed progression of the disease. Chemotherapy was started with improvement in the primary site, but he then developed a large submental mass compatible with SCC. The tumour was considered incurable at that time. Palliative radiation therapy was offered; however, he refused any further procedures or treatment., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

A 9-year-old castrated male Portuguese water dog was presented following incomplete excision of a malignant melanoma at the left lip commissure by the referring veterinarian. Physical examination was otherwise unremarkable. The patient was staged using thoracic radiographs, abdominal ultrasound, and fine-needle aspirates of the mandibular lymph nodes and spleen. Given the absence of any definitive evidence of metastasis, the malignant melanoma was surgically completely removed. The dog then received four melanoma vaccine doses as an adjuvant therapy and remained clinically healthy for more than 3 months after the last immunization. However, 232 days after the initial discovery of the lip mass, the dog was euthanized due to deterioration and a poor prognosis based on the presence of lung metastases and neoplastic melanocytic pleural effusion. The latter has been rarely reported in dogs, despite the high prevalence of oral malignant melanomas and the tendency of these tumors to metastasize to the lungs., (© 2020 American Society for Veterinary Clinical Pathology.)

We report a 7-year-old boy who presented with a nodule on the upper lip. A previous clinical history of mechanical trauma in the lesional area had been noted. After surgical excision, microscopy revealed fibrocollagenous fascicles associated with neurovascular bundles and skeletal striated muscle fibers in diffuse subepithelial distribution, suggesting rhabdomyomatous mesenchymal hamartoma. However, strict clinicopathological correlation favored a healing process with trapped striated skeletal muscle tissue. After three years of follow-up, an improvement in the aesthetic appearance of the upper lip was observed. To the best of our knowledge, a case of pseudo-rhabdomyomatous mesenchymal hamartoma has not been reported to date.

We describe the case of a 46-year-old man who presented with a four-month history of a reddish, otherwise asymptomatic, nodular lesion that involved the mucosal side of the upper lip. The lesion consisted of myoid glomus-like cells arranged around branching and thin-walled haemangiopericytoma-like vascular structures, and was classified as glomangiopericytoma. No recurrences occurred during an eight-month follow-up. To the best of our knowledge, this tumour has never previously been described in the mucosa of the lip., (Copyright © 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

The presence of multiple primary oral squamous cell carcinomas (SCCs) in a single patient is rare in dental practice. A 63-year-old man was referred for evaluation of a single tongue lesion. No lymphadenopathy was detected on extraoral examination. However, multiple asymptomatic ulcerated and crusted lesions were observed on the vermilion border of the lower lip. The intraoral examination revealed an extensive, painful endophytic ulcer of 3 months' duration on the right lateral border of the tongue. No additional findings were observed. Incisional biopsies were performed, and the histopathologic analysis confirmed the diagnosis of SCCs. The patient was referred for oncologic therapy. Surgery was the treatment of choice for both the extraoral and intraoral lesions. No disease was found after 5 months of follow-up. Although uncommon, multiple oral SCC lesions can appear to be clinically similar to deep infectious disease. Metachronous tumors were diagnosed in this patient in light of the probable course of onset of the lesions. A rigorous clinical examination that includes the lips is essential to make an accurate diagnosis and refer the patient for appropriate treatment.

Glomus tumours in the lip are extremely rare with only 13 cases, including this one, recorded in the English language that we know of. We report a 45-year-old woman with a firm, mildly painful lump in her upper lip. Excisional biopsy examination and histopathological analysis showed it to be a subtype of glomus tumour called a glomangioma., (Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.)

Purpose: Many authors have described clinicopathologic parameters as factors related to cervical lymph node metastasis development in C N0 stage lip cancer. However, predictive factors for occult lymph node metastasis and criteria for elective neck dissection, especially for early tumour, remain undefined., Methods: A multi-institutional study with 193 consecutive patients with early lip SCC treated from January 1990 to March 2006 was carried out retrospectively to determine factors predicting occult metastasis., Results: The overall late LNM rate was 13% (25/193). In the multivariate logistic regression study, tumour size and pattern of tumour invasion were factors related to the occurrence of late LNM with rates of sensitivity, specifity and accuracy for occult LNM prediction of 50%, 89.5% and 87%, respectively., Conclusion: Our results indicate that patients with stage I and II SCC of the lip with tumour size greater than 18 mm and more aggressive pattern of invasion must be considered a high-risk group for LNM and an END should be performed.

Multinucleate cell angiohistiocytoma (MCA) represent an uncommon benign fibrohistiocytic vascular lesion that sometimes may go undiagnosed because of its clinical and histopathological similarities with benign fibrous histiocytoma and other soft-tissue neoplasms especially when localized on oral cavity or semi mucosa. We report the case of a solitary multinucleate cell angiohistiocytoma on the lower lip of a 46-year-old woman suggesting that this rare lesion should be considered in the differential diagnosis of the oral soft-tissue neoplasms.

Solid organ transplant recipients have an increased risk of lip cancer, but the reasons are uncertain. Using data from the Transplant Cancer Match Study, we describe the epidemiology of lip cancer among 261 500 transplant recipients in the United States. Two hundred thirty-one lip cancers were identified, corresponding to elevated risks for both invasive and in situ lip cancers (standardized incidence ratios of 15.3 and 26.2, respectively). Invasive lip cancer incidence was associated with male sex (adjusted incidence rate ratio [aIRR] 2.01, 95% CI 1.44-2.82), transplanted organ (0.33, 0.20-0.57, for liver transplants and 3.07, 1.96-4.81, for lung transplants, compared with kidney transplants), and racial/ethnic groups other than non-Hispanic whites (0.09, 0.04-0.2). In addition, incidence increased with age and during the first 3 years following transplant, and was higher in recipients prescribed cyclosporine/azathioprine maintenance therapy (aIRR 1.79, 95% CI 1.09-2.93, compared with use of tacrolimus/mycophenolate mofetil) and following a diagnosis of cutaneous squamous cell carcinoma (4.21, 2.69-0.94). The elevation in lip cancer incidence is consistent with an effect of immunosuppression. Notably, the very strong associations with white race and history of prior skin cancer point to an important role for ultraviolet radiation exposure, and cyclosporine and azathioprine may contribute as photosensitizing or DNA damaging agents., (© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.)

A 58-year-old woman presented with a 30-day history of a moderately painful enlarging nodule on her upper cutaneous lip. Two weeks prior to presentation, she fell on the sidewalk leading to injuries of the oral mucosa, right temple, and knees. Physical examination revealed a 1.3-cm erythematous crusty nodule on the upper cutaneous lip and vermillion border resembling a keratoacanthoma-type squamous cell carcinoma. With gentle compression, a tooth was expressed from the wound. Dental traumas are usually associated with damage to the surrounding tissues, varying from bruises to deep lacerations. Potential complications include abscess formation and neurovascular damage. Tooth fragments, if undetected at the time of trauma, may remain undiagnosed for longer periods, leading to infection and disfiguring fibrosis., (Copyright © 2018 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

Myopericytomas are rare benign tumors that show a distinctive, concentric perivascular proliferation of oval to spindle-shaped myoid-appearing cells that are predominantly arranged concentrically around thin-walled vascular channels. These lesions are similar in histologic appearance to hemangiopericytomas, myofibromas, and glomus tumors. The myopericytoma is usually found in the distal extremities, but a handful of reports have shown the lesion to be present in the oral cavity. A review of the literature to date shows only 4 other reported cases of myopericytomas occurring in the lips. We describe a case of myopericytoma in the lower lip of a 42-year-old woman., (Published by Elsevier Inc.)

We report a case of microcystic adnexal carcinoma in a 80-year-old woman. This is a rare malignant adnexal cutaneous tumor with glandular and follicular differentiation, rare, often asymptomatic, with late diagnosis and slow growth, locally aggressive and rarely metastatic. The distinction with other benign and malignant skin tumors is difficult., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Competing Interests: There are no conflicts of interest.

Aim: This report shows an incidental finding of Warthin tumor in upper lip mucosa during hospitalization for a biting lesion of cheek mucosa MATERIALS AND METHODS: A 32-year-old male affected by a biting lesion of cheek mucosa was presented at Maxillo- Facial Unit of Federico II University. Clinical examination showed as an incidental finding a solid mass in the superficial layer of upper lip mucosa. We performed mini-invasive surgical treatment to obtain a radical excision of the cheek lesion at the same time as excision of Warthin tumor., Results: a follow up of 12 months was performed. The complete healing of the two wounds was achieved, with no recurrence of any of the pathologies., Discussion: The location of this Warthin tumor of minor salivary glands is very unusual. The role of imaging in diagnosis of Warthin tumor of minor salivary glands is to define localization, shape and dimension, contour, malignant features, nodal involvement. The role of fine needle aspiration cytology (FNAC) is critical in the diagnosis and therapy of minor salivary gland tumors. The surgical treatment in patients affected by Warthin tumour of minor salivary glands is local excision with a wide tumor free margin to prevent potential recurrence., Conclusions: Warthin tumor of minor salivary glands is a rare disease. We report a singular case of Warthin tumor localized in the upper lip mucosa, found as an incidental finding during a recovery for a biting lesion of cheek mucosa., Key Words: Incidental finding, Minor salivary glands, Warthin tumor.

To evaluate the clinicopathological characteristics, high-risk lifestyle factors (HRLF: chronic exposure to sun, betel quid, alcohol, and tobacco), and prognostic factors of lip cancer. The hospital records of patients with pathologically confirmed lip squamous cell carcinoma (LSCC, n = 112) and lip basal cell carcinoma (LBCC, n = 21) were reviewed. Differences in clinicopathological characteristics between LSCC and LBCC, upper and lower lip, and status of second primary tumors were compared by chi-square test and logistic regression. The prognostic factors for LSCC were analyzed by Cox regression. Compared with LBCC patients, LSCC patients were men-predominant (p < 0.001), had younger ages at onset (p < 0.001), and higher rates of lower lips involvement (p < 0.001) and HRLFs. Patients with second primary tumors were highly associated with lower lip cancer involvement (adjusted odds ratio = 2.91, p = 0.03). Patients with lower lip cancer had more HRLFs with an increasing linear trend (p = 0.004). The poorer prognostic factors of LSCC for disease-specific survival were advanced stage III/IV [crude hazard ratio (CHR) = 11.16, p < 0.001], tumor dimension >4 cm (CHR = 8.19, p = 0.006), lymph node involvement (CHR = 11.48, p < 0.001), and recurrence (CHR = 3.96, p = 0.01); whereas for disease-free survival were moderately to poorly differentiated LSCC (CHR = 4.97, p = 0.002) and alcohol consumption (CHR = 3.13, p = 0.04). LSCC and lower lip cancer were highly associated with HRLFs., (© 2017 APMIS. Published by John Wiley & Sons Ltd.)

Although head and neck squamous cell carcinoma represents one of the most common cancers among adults, it is rare in pediatric patients. The purpose of this report is to discuss the case of a 15-year-old male patient referred by his dentist due to a three-month old ulcer in his lower lip. The patient denied tobacco smoking and drinking alcohol, and confirmed that he performed manual labor in a brick yard, being exposed daily to the sun without protection. Clinical examination revealed an exophytic rounded ulcer in the right lower lip, measuring 1.5 cm, with a flaky bed. An incisional biopsy was performed, and histopathologic analysis confirmed the diagnosis of squamous cell carcinoma. The treatment of choice was surgical excision. Malignancy should be included in the differential diagnosis of chronic oral ulcers in children and adolescents. Moreover, chronic sun exposure might be associated with occurrence of lip squamous cell carcinoma.

This report describes a case of labial angioleiomyoma in a 52-year-old woman. The patient had noticed a slow-growing painless isolated mass in her upper lip for 6 months. The mass was surgically excised, and pathological examination was consistent with angioleiomyoma. Surgical excision was curative, and there was no recurrence at 12-month follow-up., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)