Squamous cell carcinomas of the lower lip.

During a 10-year period, 30 patients with lesions of the lower lip, suspected to be cancerous, were operated on by primary resection without a prior biopsy. The patients have been continuously followed to evaluate if the treatment strategy, with avoidance of an incisional biopsy, might influence local recurrence and metastatic rate. One patient developed a second primary lesion, and none of the patients had local recurrences. Local lymph node metastases were detected in two patients. There was full agreement between the initial clinical and histopathological diagnosis among 26 patients with squamous cell carcinomas. In another two patients, the histopathological examination revealed severe epithelial dysplasia, and finally one case was diagnosed histopathologically as a keratoacanthoma. In 29 out of the 30 cases, a pre-treatment biopsy would not have influenced the extent of the surgical procedure.