Unusual growth of upper lip squamous cell carcinoma: a case report.

Introduction: Squamous cell carcinoma is the most common type of lip and oral cavity cancers. In majority of cases it follows quite common course, and after the surgery it does not produce any harm. This case presents unusual and unexpected growth of upper lip squamous cell carcinoma with severe cosmetic problems, and possible health threats.

Case presentation: A 46-year-old woman noticed on her upper lip "a spot, the size of a wheat grain", which grew rapidly and reached the size of 0.6 cm during a two-week period. The lesion was red, hard and painful, attached to the skin. It was surgically removed, and primary histopathological finding was follicular keratosis. Recurrent tumor appeared seven days after the operation, with the extreme swelling of the upper lip. The patient was sent to a tertiary hospital, where fungal or bacterial infection was excluded. The change on the patient's upper lip reached the size of 5 × 2 cm, as soft, reddish nodular tumor. Squamous cell carcinoma was diagnosed after the histopathological audit. With the second surgical intervention the tumor was removed and the defect reconstructed.

Conclusions: Prognosis of this type of tumor, apart from its size and differentiation level, depends on infiltration in tumor-surrounding tissue, perineural and perivascular spread. Therefore, it is always necessary to analyze the removed skin especially on margins.