Clinical problems in the surgical management for pleomorphic adenoma on the lip

Abstract

It has been considered difficult to both obtain radicality of tumors and maintain normal shape and function of the lip in minor salivary gland tumor surgery. For this reason, simple enucleation by blunt dissection has often been chosen as the method of surgery in such a case, although it might cause recurrence from residual tumor cells. A 50-year-old man who had a large tumor sized 30×20×15 mm on the upper lip was referred to our hospital on March 28, 1984. Though no positive findings of malignancy were detected clinically, simple enucleation was not carried out because it was considered an inadequate method to excise the tumor completely. The tumor and mucosa which overlaid it were excised entirely by sharp dissection, and the orbicularis oris muscle was partially dissected as a minimal safety margin for complete removal of the extra- capsular invasion. Pleomorphic adenoma was immediately confirmed by frozen section, no histological malignancy was found and radicality was also confirmed. The defect of the oral mucosa was covered by lyophilized dura with tie- over suture, and well epithelized without any deformity and dysfunction 3 weeks postop.