. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. Glandular enlargementis soft and isolated. Ulcerated cavernoma (cavernous angioma) of thelip may have a cancerous appearance, but it usuallyoccurs in children and is generally associated withother anomalies of the blood-vessels. The induration of fissures of the lips resultingfrom chronic eczema heals quickly under rationaltreatment, and is thus distinguished from carcinoma-tous induration. It is important to note that cancer of the lip occursnot only in old people but also soon after


. Atlas of clinical surgery; with special reference to diagnosis and treatment for practitioners and students. Glandular enlargementis soft and isolated. Ulcerated cavernoma (cavernous angioma) of thelip may have a cancerous appearance, but it usuallyoccurs in children and is generally associated withother anomalies of the blood-vessels. The induration of fissures of the lips resultingfrom chronic eczema heals quickly under rationaltreatment, and is thus distinguished from carcinoma-tous induration. It is important to note that cancer of the lip occursnot only in old people but also soon after the thirtiethyear. Treatment. All depends on early diagnosis, forthe cuneiform excision of small tumors gives the bestchance of a radical cure. In doubtful cases excisionis to be preferred to antisyphilitic or antitubercu-lous treatment, so as to lose no time. In extensivegrowths, from one and one half to two centimeters ofhealthy tissue should be removed round the tumors,and the neighboring parts suspected of disease, suchas bones and buccal mucous membrane, should also 8 Bockenheimer, Atlas. Tab. Ill. Fie. 5. Carcinoma labii inferioris — Tuberculosis cutis. Rebman Company, New-York. be removed. The defect can be repaired by plasticoperations, the best of which are Dieffcnbachn orJacsches. Palpable glands should always be removed byseparate incisions in the submental and submaxillaryregions. The submaxillary gland which is oftenaffected is best removed at the same time. By radicaloperation a permanent cure is possible even inextensive carcinomas. Fig. 3 shows a carcinoma involving the wholelower lip. Deep ulcerations alternate with papillo-matous outgrowths. In some parts there are scabson the surface of the ulcers, in others isolated yellowepithelial plugs. The growth is hardly movableover the lower jaw, and is on the point of extendingto the buccal mucous membrane. After free exci-sion of the tumor, removal of the enlarged glands inthe submental and submaxillary regions,


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