As already pointed out, the basal-celled growths do not metastasize to the lymph glands and arc cured by a local operation. On the other hand, the commoner prickle-celled tumors speedily metastasize, and the presence of one demands not only local removal, but also removal of the glands of the neck because of the rich lymphatic drainage of the lips. Of course, it must not be overlooked that any ulcerating tumor of the lips may cause enlargement of the glands from simple inflammatory hyperplasia. In Bloodgood's statistics concerning malignant tumors of the lower lip, published in 1910, there were 100 spinocellular tumors, 2 cubocellular neoplasms (which we can include with the preceding), and only 4 basal-celled growths. In contrast, his figures concerning cancer of the upper lip showed 4 spino-celled growths and 9 basal-eelled ones.

In determining the relative malignancy of a tumor of the lip, certain general rules hold as for epithelial tumors upon other portions of the body. Long duration, no history of any active growth, absence of enlarged draining glands, tendency to remain pedunculated, a lack of definite induration at the base, all point in favor of a more benign type of growth.

Fungating cancer of the lower lip

Fig. 80.-Fungating cancer of the lower lip of five years' duration. (Heidingsfeld's collection).