Etiologic clues to lip cancer from epidemiologic studies on farmers.
OBJECTIVES: This study examined the risk factors for lip cancer among farmers. METHODS: A series of meta-analyses of peer-reviewed studies of lip cancer and farming were performed using 21 studies published between 1981 and 1997. Prior to the meta-analyses, all the studies were reviewed and evaluated for heterogeneity and publication bias. Combined relative risks (RR) were calculated using the random effect model. RESULTS: The combined RR for lip cancer was 2.0 [95% confidence interval (95% CI) 1.74-2.30] for all the studies and 1.28 (95% CI 0.79-2.08) for studies involving female farmers. Additional meta-analyses were undertaken on a subset of studies reporting on skin cancer among farmers. The combined RR for nonmelanotic skin cancer was 1.0 (95% CI 0.89-1.14), and for malignant melanoma it was 0.88 (95% CI 0.74-1.05). CONCLUSIONS: The findings suggest that male farmers have a significantly elevated risk for lip cancer. Lip cancer and skin cancer do not share a common etiologic factor. Besides sunlight exposure, other factors such as viral infection or reduced immunity may play a role in the etiology of lip cancer. (+info)
Malignant mesothelioma in subjects with Marfan's syndrome and Ehlers-Danlos syndrome: only an apparent association?
Malignant mesothelioma is a rare neoplasm which could be favored by an hereditary predisposing factor. So far, malignant mesothelioma have never been described in patients with hereditary diseases of the connective tissue. Here, we report some cases of mesothelioma affecting subjects who were not exposed to inhalation of asbestos. One of these subjects was affected by Ehlers-Danlos syndrome, whereas in two brothers, mesothelioma was associated with Marfan's syndrome. The observation of the same histologic subtype of mesothelioma in two brothers and the coexistence of two pathologic conditions of mesodermal origin indicate the presence of hereditary factors predisposing to the cancerogenic action of even small amounts of asbestos. Structural alterations of collagen and primary immunodeficiency may represent the host factor inducing development of the neoplasm. We conclude that the association between these rare disorders of the connective tissue and mesothelioma may not be coincidental, but could be the result of the exposition to small amounts of asbestos in predisposed individuals. (+info)
Acquired tufted angioma of the lower lip mucosa.
The acquired tufted angioma is a unique, dusky red, vascular proliferation previously reported in the skin, usually developing in childhood or in young adults, which exhibits a distinctive microscopic appearance. Clinically, the condition enlarges at a variable rate, becomes stable and may regress spontaneously. A small, long-standing, vascular lesion of the mucosa of the lower lip, exhibiting microscopic and immunohistochemical features resembling those of acquired tufted angioma, is reported. The differential diagnosis, including pyogenic granuloma, capillary hemangioma and hemangiopericytoma, is discussed. (+info)
Tobacco-associated lesions of the oral cavity: Part II. Malignant lesions.
Nonmalignant tobacco-associated lesions of the oral cavity were discussed in the first part of this two-part article. Here, we describe malignant lesions associated with tobacco use, basic biopsy principles for such lesions and intervention strategies that dental professionals may use to reduce the chances of their patients developing precancerous lesions or primary malignancies. (+info)
Regional guideline for diagnosis and treatment of squamous cell carcinoma of the lip: what is the level of compliance?
OBJECTIVE: To investigate to what extent physicians comply with a regional guideline for the diagnosis, staging, treatment and follow-up of patients with squamous cell carcinoma of the lower lip. DESIGN: Retrospective analysis of data from the medical records of 248 patients diagnosed with squamous cell carcinoma of the lower lip during the period 1989-1997. SETTING: Comprehensive Cancer Centre of the Northern region of the Netherlands. STUDY PARTICIPANTS: The data were collected by this Centre for the regional population-based cancer registry. RESULTS: Overall compliance with the separate guidelines varied between 4 and 80%. For diagnosis and staging, the guideline was followed for 4-70% of patients. The type of treatment in relation to age conformed to the guideline in 34% of cases. Of the 208 surgically-treated patients, treatment was performed in accordance with the guidelines in 92 (44%) patients, compared with seven out of 18 (39%) patients who received radiotherapy. Follow-up in accordance with the guideline was 11% in the first year, 9% in the second year and 21% in the third year. CONCLUSION: Only a minority of patients with squamous cell carcinoma of the lower lip, a rare rumour, were managed according to the available regional guideline. Regular review of both the guideline and its implementation is necessary in order to optimize its use. (+info)
Pigmented villonodular synovitis in multiple joints. Occurrence in a child with cavernous haemangioma of lip and pulmonary stenosis.
A case is presented of pigmented villonodular synovitis involving three joints in a 7-year-old girl. The diagnosis was confirmed at surgery and by histology. The patient also exhibited a haemangioma of the upper lip and a congenital pulmonary stenosis of mild degree. Subtotal synovectomy of the right knee and of both ankles was performed. The lesion recurred in both ankles after 6 months. Review of the literature failed to reveal any previous report of multiple joint involvement by pigmented villonodular synovitis in childhood and it appears that simultaneous involvement of three joints has not previously been described. Scintiscanning with 99mTc stannous pyrophosphate showed increased vascularity of the involved joints immediately after injection, but no increased osteoblastic activity was seen on the delayed scan. This radionuclide scanning technique is therefore helpful in distinguishing pigmented villonodular synovitis from other arthropathies. (+info)
Lifestyles, environmental and phenotypic factors associated with lip cancer: a case-control study in southern Spain.
The aim of this study was to identify factors related to lip cancer (LC) considering individual characteristics and sociodemographic factors. A case-control study was carried out in the province of Granada (Andalusia, southern Spain). The cases were 105 males with squamous-cell carcinoma of the lip, diagnosed between 1987 and 1989 (aged 20-70 years) and identified by means of a population-based Cancer Registry. As controls, a randomised populational sample of 239 males, stratified by age, was used. Multiple logistic regression analysis showed that risk factors are lifetime cumulative tobacco consumption and alcohol consumption. An interaction was found between alcohol consumption and the smoking habit (leaving the cigarette on the lip): OR=23.6; 95% CI: 3.9-142.0. Other risk factors identified are clear eyes (OR=3.5; CI: 95% 1.5-8.0), sun exposure early in life and cumulative sun exposure during outdoor work (OR=11.9; 95%: CI: 1.3-108.9), and skin reaction to sun exposure (Fitzpatrick levels). Another interaction was found between skin reaction and a previous history of common sporadic warts (OR=4.4; 95% CI: 1.01-19.1). We conclude that LC is related to phenotype, skin reaction to sun exposure, cumulative and early sunlight exposure, and tobacco and alcohol consumption, as well as a low educational level. Leaving the cigarette on the lip is predictive of LC risk irrespective of cumulative tobacco consumption. (+info)
A STATISTICAL REVIEW OF CARCINOMA OF THE LIP.
Among 3166 patients with microscopically confirmed squamous cell carcinoma of the lip registered at The Ontario Cancer Treatment and Research Foundation's Regional Clinics in 1938-1955, the five-year crude survival rate was 65%, and the five-year net survival rate 89%. Survival was influenced by age, site and size of primary lesion, local and regional invasion, long delay, and treatment method. The initial treatment appeared to control the primary lesion in 84% of cases and involved lymph nodes in 58%. The net survival rates improved over the survey period. Findings confirm the usefulness of the proposed TNM staging. (+info)