PMC5310141_01
Frontal preoperative view showing diffuse severe enlargement of both the lips, with fissuring in the midline of the lower.
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A 30-year-old man of African descent came to our attention because of an extremely severe swelling involving both lips (Fig. 1).
Histopathological examination of an incisional biopsy taken from the upper lip showed numerous dilated lymphatic vessels and a mild inflammatory infiltrate composed of lymphocytes and rare non-caseating granulomas in the subepithelial connective tissue (inset), consistent with a diagnosis of Miescher's cheilitis.
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Histopathological examination showed numerous dilated lymphatic vessels and a mild inflammatory infiltrate, composed of lymphocytes and rare non caseating epithelioid granulomas in the subepithelial connective tissue (Fig. 2), consistent with a diagnosis of Miescher's cheilitis.
(a) Preoperative frontal view; (b) and (c) Transverse sickle-shaped mucosa en block removal between 1.2 and 1.5 cm dorsal to the vermillion border; (d) Removal of the mucosal excess; (e) Immediate postoperative frontal view.
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To reduce the pronounced anterior projection of the vermillion, the patient underwent a transverse sickle-shaped mucosa en block removal between 1.2 and 1.5 cm dorsal to the vermillion border, basing on Conway's technique (Fig. 3).
One year post op follow-up frontal view.
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After 12-months follow-up, the patient did not show local recurrence of the disease and the oral continence was preserved, with normal lip sensation (Fig. 4).