Advanced squamous-cell carcinoma of the lower lip
Fred Bernardes Filho, Priscila Vinhal Grupioni
The Pan African Medical Journal. ;30:148. doi:10.11604/pamj..30.148.14352

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Images in clinical medicine

Advanced squamous-cell carcinoma of the lower lip

Fred Bernardes Filho, Priscila Vinhal Grupioni
Pan Afr Med J. 2018; 30:148. doi:10.11604/pamj.2018.30.148.14352. Published 20 Jun 2018

A 37-year-old male patient was admitted at the emergency room with headache, severe pain and bleeding in the tumor. He had a previous diagnosis of squamous-cell carcinoma of the lower lip two years before, however, despite having been informed of the need to excise the initial lesion, he refused treatment due to religious beliefs. The patient returned to seek treatment after 18 months of diagnosis, however the tumor already had great extent, being unresectable. The lesion did not respond to chemotherapy. On examination, the tumor affected all of the right hemiface, with ocular and nasal destruction; jaw and tongue exposure and severe bleeding were present. Unfortunately the patient died 12 days after the hospital admission. Although informed consent allows patients to make treatment decisions based on the most information possible and patient's right to determine his or her treatment, there are a small number of adherents to religious faiths that proscribe conventional care. Despite the efforts for early diagnosis, patients continue to neglect seeking timely treatment. In our case, this was directly responsible for the patient's poor prognosis.

Corresponding author:
Fred Bernardes Filho, Dermatology Division, Department of Medical Clinics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil

©Fred Bernardes Filho et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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