Uncommon Clinical Appearance and Localisation of Carcinoma of the Upper Lip - Case Presentation

Abstract

U radu se prikazuje neobična klinička slika i lokalizacija karcinoma gornje usnice. Pacijentica K. A., sedamdesetčetiri godine, dolazi u ambulantu za oralnu medicinu radi gnojnog infiltrata u gornjoj usnici sa sumnjom na ubod kukca. Uputi se u ambulantu za oralnu kirurgiju gdje se učini incizija i drenaža te se postavi dijagnoza piogenoga granuloma. Kako promjena u međuvremenu od mjesec-dva ne prolazi već postaje sve tvrđa i vidljivija, i vestibularno i labijalno, naruči se na ekciziju. U međuvremenu pacijentica odlazi na Kliniku za dermatovenerologiju zbog bazocelularnih promjena na licu. U tijeku ekscizija promjena lica učini se i površna biopsija s kožne strane usnice te se dobije PHD nalaz planocelularnoga karcinoma. Pacijentici se na klinici za dermatovenerologiju savjetuje radioterapija promjene, no pacijentica se ponovno javlja u ambulantu oralne kirurgije. Zbog sumnje u površno uzet nalaz promjene i eventualne zamjene s mioblastomom zrnatih stanica, učini se ekscizija promjene u cijelosti te se dobije identičan PHD nalaz planocelularnoga karcinoma. Tada se pacijentica dogovorno premjesti u KKLČU KB “Dubrava” gdje se učini proširena ekscizija, te se PHD-om utvrdi da je promjena u predhodnom zahvatu ekscidirana u cijelosti.The study presents the uncommon clinical appearance and localisation of carcinoma of the upper lip. A 74-year-old female patient was referred to the Outpatient Department of Oral Medicine because of a purulent infiltrate in the upper lip which was thought to be an insect bite. She was referred to the Outpatient Department of Oral Surgery where an incision was performed and drainage, and piogenic granuloma diagnosed. As the lesion had not healed after two months, but on the contrary had become harder and more visible, both vestibularly and labially, an excision was planned. In the meantime, however, the patient had attended the Clinic of Dermatovenerology because of basocellular lesions on the face, and during excision of the facial lesions a surface biopsy was performed from the skin side of the lip, and the PHD finding showed planocellular carcinoma. At the Clinic of Dermatovenerology the patient was recommended to undergo radiotherapy of the lesions. However, the patient returned to the Out-patient Department of Oral Surgery. Because of the suspicion that the biopsy had been too superficial and because of the possibility of eventual confusion with a mioblastoma, complete excision of the lesion was performed and an identical PHD finding was obtained of planocellular carcinoma. The patient was then transferred to the Department of Maxillofacial Surgery, University Hospital Dubrava, where an extended excision was performed, and the PHD confirmed that the lesion had been completely excised in the previous procedure