In classifying the malignant tumors of the lips, mention must be made of sarcomata. Certain of the angiomata undergo malignant change, and must receive radical surgical treatment. More rarely, small round or spindle-celled sarcomata occur upon the lip. Marklcy* has recently reported such a case and collected several others from the literature. His patient was 65 years of age, and, because of this fact and because of the involvement of the ccrvical glands, diagnosis of carcinoma was made, but the microscope showed the lesion to consist of small round cells, a typical sarcoma As the tumor had been present for six months before radical operation was done, the prognosis was naturally bad. These tumors metastasize early, cither through the blood stream or through the lymphatics, and operation must be done very early in order to save the patient.

Flg. 77.-Ulcerated prickle-celled carcinoma of the lower lip In a negro, of two years' duration. (Author's i-ollectldh).

Carcinomata

The epithelial tumors of the lip are the most important for our consideration, for they are the common growths that demand surgical treatment. The lip cancers may be grouped under two headings-the squamous- or prickle-celled type and the basal-celled variety. The malignant warts also deserve consideration, although they are practically always prickle-celled in origin. This classification is based on that of Krompecher. The cubocelled tumors are best included with the squamous-celled neoplasms, for they arc of almost similar malignancy, and hence require the same treatment.

*Markley: Jour. Amcr. Med. Assn., 1913, Ixi. 334.