Histopathology Report

Final reports of lip resection specimens should include details on:

• the specimen type, size and side.

• the type of tumour present:

- squamous cell carcinoma NOS.

- adenocarcinoma (salivary gland types).

• the grade of tumour assessed at invasive front.

• the extent of local spread.

• the distance of tumour from the nearest lateral mucosal margin.

Oral mucosa -Minor salivary glands^

Labial artery Oral mucosa Minor salivary glands -

Tumour

Labial artery Oral mucosa Minor salivary glands -

Lower Lip Wedge Excision

Vermilion border

Tumour

Tumour

Vermilion border

Tumour Skin Oral mucosa

Minor salivary glands

Tumour

Tumour Skin Oral mucosa

Minor salivary glands

Vermilion border

Skin

Orbicularis oris

Tumour

Orbicularis oris b

Vermilion border

Skin

Orbicularis oris

Tumour

. True surgical limit

Figure 13.5. Wedge resection of lower lip. Suggested siting and orientation of blocks for wedge resection of lip. (a) View from in front. (b) Outline of central block(s). (c) Selection of transverse limits if original limit blocks contain tumour.

• the distance of the tumour from the nearest deep margin.

• intravascular and/or perineural spread.

• other pathology such as solar damage, dysplasia or radiation injury.

• TNM classification of tumour spread lip and oral cavity pTis carcinoma in situ.

pT1 tumour < 2 cm in greatest dimension.

pT2 tumour > 2 cm but < 4 cm in greatest dimension.

pT3 tumour > 4 cm in greatest dimension.

pT4 Lip: tumour invades adjacent structures, e.g., through cortical bone, inferior alveolar nerve, floor of mouth, skin of face.

Oral cavity: tumour invades adjacent structures, e.g., through cortical bone, into deep (extrinsic) muscle of tongue, maxillary sinus, skin.

Regional lymph nodes pN0 no regional node metastasis.

pN1 metastasis in a ipsilateral single < 3 cm.

pN2 metastasis in:

a. ipsilateral single >3 to 6 cm.

b. ipsilateral multiple < 6 cm.

c. bilateral, contralateral < 6 cm. pN3 metastasis in a lymph node > 6 cm.

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