Red moles - hemangiomas: causes of appearance on the body and types

At the end of the last century, malignant tumors of the oral cavity were considered a concomitant disease of wastrels due to the abuse of tobacco and alcohol. Today, experts also include the human papilloma virus among the causes of cancer in this localization, so the frequency of all head and neck tumors has increased significantly.

• What precedes cancer
• When should a malignant process be suspected?
• Stages of lip cancer
• How to treat

Head and neck cancer ranks sixth in the world among all malignant tumors and will soon be in the TOP-5, but, unlike its “brothers” in localization, the detection rate of lip cancer is not increasing, but is steadily decreasing.

The incidence of lip cancer has decreased by more than 16% over the past 5 years. In 2022, carcinoma was detected in 2,235 Russians, with men getting sick 2.7 times more often.

• Out of 100 thousand people, 29 Russians develop the disease, and at a more mature age than a decade ago.
• The average age of affected women is 75.5 years; in them, the tumor is often localized on the upper lip.
• In men, cancer is diagnosed on average 8 years earlier, in most cases on the lower lip.
• In 87.6%, the disease is detected at stages 1-2, stage 3 with metastases to the lymph nodes is diagnosed in 8%, and stage 4 in 4.6%.

Types of acquired red moles on the body

• Simple (capillary). Proliferation of newly formed capillaries, small venous and arterial vessels. Looks like a red spot.

• Cavernous. A spongy cavity with blood - a red or bluish nodule. Often forms under the skin.

• Branched (racellose). A plexus of tortuous dilated capillary trunks. They pulsate, noise and trembling are detected. It is rare and occurs on the extremities or face. If injured, life-threatening bleeding may occur.

How to identify hemangioma? Press on top of it and it should fade or disappear.

Diagnostics

You can determine why a lump appears on your lip using diagnostic procedures:

1. Inspection and palpation of the growth on the lip, detailed questioning of the patient, study of the anamnesis.
2. Taking general and biochemical blood and urine tests.
3. Hardware studies: ultrasound, x-ray, probing of gland ducts, sialography.

Instrumental diagnostics are used for neoplasms on the lip: cysts, tumors.

Are red moles dangerous?

In themselves, these formations are harmless and are not precancers.

If you have a lot of red moles on your body, the cause may be a serious liver or pancreas disease. Pay attention to this - this is a reason for examination.

Problems may arise in case of traumatization of hemangiomas. Even fairly small formations threaten heavy bleeding, which is not easy to stop.

Clinical case

Patient L, 26 years old, presented with a traumatized mass in the axillary region. According to her, she tore off a convex hemnagioma with the edge of a rigid corset of a wedding dress almost a few minutes before the start of the wedding ceremony. The hemangioma bled very heavily and a large blood stain appeared on her white dress. She had to wear the witness's jacket over her wedding dress. It was in such a strange outfit that the wedding took place.

What precedes cancer

The lips are muscles covered with tissue and skin, which is called the “red border”. The inner part, covered with the mucous membrane, anatomically belongs to the vestibule of the oral cavity, and tumors arising there are no longer considered labial. A malignant tumor of the lip can arise out of nowhere - practically out of nowhere, and since this disease is considered to belong to a not very socially prosperous population, cancer in this localization is often preceded by skin diseases of the red border of the lips. These pathological conditions are classified as precancerous, although not all of them become fertile ground for the development of a malignant process.

Precancerous processes are similar in appearance, but differ in cellular structure. Precancerous lips are characterized by hyperplasia - excessive cell growth, frequent cell division, however, within the strictly prescribed framework of nature, and not endlessly, as in a malignant process. Cells of irregular shape appear, prone to rapid keratinization, which is manifested by hyperkeratosis - scaly dry skin. All lip diseases are seriously treated surgically or with close-focus radiotherapy.

• Previously, Bowen's disease was classified as an obligate precancer - a condition that, if persisted for a long time, was highly likely to develop cancer. In reality, cancer develops at the site of this “sore” in approximately every sixth patient. Today the disease is already considered cancer in situ - stage 0 cancer. With Bowen's disease, a spot with small nodules and papillae, velvety or smooth, sometimes with superficial ulcers - erosions, lives and grows on the lip for a long time.

• Erythroplasia Keira, a bright red lump with clear contours that rises above the skin, is no less likely to become a cause for the development of lip cancer. Over time, the lump ulcerates and is also considered stage 0 cancer.

• Manganotti's abrasive cheilitis is a pathology in which most often polished erosions with raised edges appear in the center, become covered with crusts and even heal on their own, but certainly recur.
• In young men, a bulging area with white scales surrounded by inflamed tissue may appear on the lower lip - this is limited hyperkeratosis of the red border of the lips.
• The lip is also affected by a variety of leukoplakia, often with small warts, plaques and erosions, which threatens every fourth patient with lip cancer.
• Keratoacanthoma is a semicircular fat cyst covered with scales, with a depression in the center similar to a volcanic crater. The pathology affects the lower lip, as a rule, of rural men, and in the elderly it is single, and in the young it consists of several nodules.

Links[edit]

1. ^ a b c
   Rajendran A;
   Sundaram S. (February 10, 2014). Schafer's Textbook of Oral Pathology
   (7th ed.). Elsevier Health Sciences APAC. pp. 16–17. ISBN 978-81-312-3800-4.
2. ^ a b c
   Rapini, Ronald P.;
   Bologna, Jean L.; Iorizzo, Joseph L. (2007). Dermatology: 2-volume set
   . St. Louis: Mosby. ISBN 1-4160-2999-0.
3. McKusik, Victor Alexandrovich (May 27, 2009). "Commissural pits of the lips". Internet-Mendelian Inheritance in Man
   . Retrieved May 22, 2022.

How to treat

Recommendations for the treatment of lip cancer are based not on clinical studies, as is customary for the vast majority of malignant tumors, but on decades of practical experience. It so happens that, due to the rarity of the disease, no randomized clinical trials have been conducted anywhere in the world. The choice of treatment is determined by the size of the primary tumor and, of course, the expected cosmetic defect. Even a small lip tumor changes a person’s quality of life much more than all other cancers. It is too noticeable, as is the scar that remains after its removal.

When treating cancer, it is important that there are no malignant cells in the surgical wound, so the tumor must be retreated in all directions. The lip itself is small, so even with a tumor measuring 5 mm, a postoperative scar of several centimeters will remain. Only after treatment of very small and superficial tumors do minor defects remain. Unfortunately, it is impossible to treat the patient in such a way that there are no defects left at all, therefore, when choosing a treatment method, they are guided by the least functional deformation and the minimum undesirable aesthetic result.

In this situation, the determining factor will be the decision of the patient who chooses the treatment option that will result in the least severe psychological consequences for him. Surgical treatment is preferable based on results, but radiation therapy, if possible, will leave fewer “traces.” With a large and superficial tumor of the lower lip, for example, a good result is likely after radiation therapy, which cannot be achieved if the cancer grows in the jaw bone. In this situation, the treatment option would be surgery.

Squamous cell skin cancer is very responsive to chemotherapy, but how lip cancer will react to cytostatics in each specific case can only be assumed, since serious and reliable studies of the effectiveness of drug therapy in this localization have not been conducted. However, for large inoperable tumors and relapses after excision, combined chemoradiation treatment has a good effect. If there are metastases to the nearest lymph nodes, the question of radical removal of regional lymphatic collectors with subcutaneous fat is raised.

Treatment of cancer in this location is purely individual, because the reconstructive possibilities of restoring lost lip volume and microsurgical leveling of the postoperative defect tend to zero. However, in most cases the patient has every chance of recovery. In case of lip cancer, it is very important to get to a good oncologist surgeon in time.

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Treatment options for tumors

1. Surgical technique (excision of the tumor, suturing it, ligation of the afferent and efferent vessels, ligation of the vessels with excision of the hemangioma, embolization of the vessels).
2. Electrocoagulation by introducing electrodes into the formation or along its perimeter).
3. Cryodestruction with liquid nitrogen is carried out for small tumor sizes and when it is superficial.
4. Laser removal that minimizes damage to surrounding healthy tissue. The procedure is carried out quickly, there are no stitches, scars or blood loss, almost complete painlessness, low risk of relapse.
5. Conservative methods are used for small lesions. They consist of sclerosing the tumor with alcohol.
6. According to indications, a combination of surgical and conservative methods is used (preliminary ligation of the vessels and sclerosis in the center).

Stages of lip cancer

Lip cancer is classified as a visual localization, because it is very easy to notice even with the naked eye. However, almost a third of patients have no complaints about the condition of their lip, and do not believe that a chronically existing crack on it could be cancer. As a rule, such patients consult a doctor for another reason, and the doctor, noticing this pathology, refers the patient for a consultation with an oncologist. This process is called “active discovery.”

In 2014, stages I–II of lip cancer were detected in 85.2% of patients, while a tumor measuring up to 2 cm is considered stage 1 cancer, stage 2 is a tumor measuring more than 2 cm and less than 4 cm. At these stages, tumors are detected without metastases to the lymph nodes and anywhere else. A lip tumor relatively rarely metastasizes to regional lymph nodes - no more than a dozen out of a hundred patients. As a rule, metastases go to the mental and submandibular lymph nodes. For infrequent tumors of the upper lip or commissure - the corner of the mouth, on the contrary, damage to the lymph nodes is rather the norm.

Stage III includes lip tumors larger than 4 cm or smaller cancer, but with metastases to the lymph node. The size of the lymph node should not exceed 3 cm. In 2014, stage III was diagnosed in 9.7% of patients. A lip tumor of any size, but with metastases to one or more lymph nodes larger than 3 cm, is already considered stage IV. Systemic metastasis to other organs in lip cancer is very rare, occurring only in every seventh patient diagnosed with stage IV cancer. The last stage was detected in 4%. Within a year after the diagnosis of a malignant neoplasm, 4.5% die, which is 120 people.