A 65-year-old farmer presents with a 1.5 cm exophytic ulcerative lesion on the lower lip vermillion border. Biopsy confirms well-differentiated squamous cell carcinoma. There is no bone involvement on imaging. Which of the following is the most appropriate primary management?
- A Radical neck dissection followed by radiotherapy
- B Definitive external beam radiotherapy alone
- C Wide local excision with V-shaped wedge reconstruction ✓
- D Commando procedure with segmental mandibulectomy
Correct answer: C. Wide local excision with V-shaped wedge reconstruction
Explanation
A small (<2 cm) squamous cell carcinoma of the lower lip without bone invasion is treated with wide local excision and primary closure, often using a V-wedge excision. Radical neck dissection is not indicated without nodal disease. Radiotherapy is reserved for cases unsuitable for surgery. Commando procedure is for advanced mandibular involvement.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.