Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Clinical
  • Published:

Basal cell carcinomas of the lips: a case series and review of the literature

British Dental Journal volume 238, pages 925–930 (2025)Cite this article

Abstract

The aim of this review was to characterise the clinical features of basal cell carcinomas (BCCs) occurring on the lips. A review of the literature was performed using PubMed to identify reports of BCCs of the lips. Additionally, a retrospective search of the archives of our diagnostic oral pathology service was performed for BCCs diagnosed between 2000-2023. There were 27 BCCs of the lips identified in the literature review. These tumours typically presented clinically as bleeding, eroded, crusted, ulcerated and/or centrally depressed nodules. Treatment included surgical excision, Mohs micrographic surgery, wedge resection and radiation. None recurred or metastasised. Ten additional cases of BCC of the lips were retrieved from our archives. Six of these BCCs exhibited a classic clinical presentation, being described as red, white, crusted, bleeding, scabbing, eroded and/or ulcerated lesions. Four tumours were considered non-classic, presenting as yellow nodules. To the best of our knowledge, this is the first report of BCCs on the lips presenting as yellow nodules. It is important for clinicians to be aware of this rare presentation of BCC in the oral and perioral region as it may mimic benign entities.

Key points

  • Basal cell carcinoma is the most common human malignancy and it exhibits a predilection for the skin of the head and neck region.

  • Basal cell carcinomas of the lips usually occur on the cutaneous surface but may rarely involve the mucosal portion of the lips.

  • Basal cell carcinomas of the lips are typically bleeding, crusted and/or ulcerated but may present as yellow nodules and mimic benign entities.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Cameron M C, Lee E, Hibler B P et al. Basal cell carcinoma: epidemiology; pathophysiology; clinical and histological subtypes; and disease associations. J Am Acad Dermatol 2019; 80: 303-317.

  2. Messina J. Basal cell carcinomas. In WHO classification of tumours editorial board: skin tumours vol 12. 5th ed. Lyon: International Agency for Research on Cancer, 2023.

  3. Souza C F, Thomé E P, Menegotto P F, Schmitt J V, Shibue J R, Tarlé R G. Topography of basal cell carcinoma and their correlations with gender, age and histologic pattern: a retrospective study of 1042 lesions. An Bras Dermatol 2011; 86: 272-277.

  4. Huynh N T, Veness M J. Basal cell carcinoma of the lip treated with radiotherapy. Australas J Dermatol 2002; 43: 15-19.

  5. Szewczyk M, Pazdrowski J, Golusiński P et al. Basal cell carcinoma in farmers: an occupation group at high risk. Int Arch Occup Environ Health 2016; 89: 497-501.

  6. Welton D G, Elliott J A, Kimmelstiel P. Epithelioma; clinical and histologic data on 1,025 lesions. Arch Derm Syphilol 1949; 60: 277-293.

  7. Bastiaens M T, Hoefnagel J J, Bruijn J A, Westendorp R G, Vermeer B J, Bouwes Bavinck J N. Differences in age, site distribution, and sex between nodular and superficial basal cell carcinoma indicate different types of tumors. J Invest Dermatol 1998; 110: 880-884.

  8. Luna-Ortiz K, Güemes-Meza A, Villavicencio-Valencia V, Mosqueda-Taylor A. Upper lip malignant neoplasms: a study of 59 cases. Med Oral Patol Oral Cir Bucal 2012; DOI: 10.4317/medoral.17501.

  9. Hwang J R, Khachemoune A. Lower lip basal cell and squamous cell carcinomas: a reappraisal of the similarities and differences in clinical presentation and management. Arch Dermatol Res 2023; 315: 117-125.

  10. Queen D, Knackstedt T, Polacco M A, Collins L K, Lee K, Samie F H. Characteristics of non-melanoma skin cancers of the cutaneous perioral and vermilion lip treated by Mohs micrographic surgery. J Eur Acad Dermatol Venereol 2019; 33: 305-311.

  11. Dawn A, Lawrence N. Significant differences in nonmelanoma skin cancers of the upper and lower lip. Dermatol Surg 2013; 39: 1252-1257.

  12. Leibovitch I, Huilgol S C, Selva D, Paver R, Richards S. Cutaneous lip tumours treated with Mohs micrographic surgery: clinical features and surgical outcome. Br J Dermatol 2005; 153: 1147-1152.

  13. De Sousa J, Sánchez Yus E, Rueda M, Rojo S. Basal cell carcinoma on the vermilion border of the lip: a study of six cases. Dermatology 2001; 203: 131-134.

  14. Weitzner. Basal-cell carcinoma of the vermilion mucosa and skin of the lip. Oral Surg Oral Med Oral Pathol 1975; 39: 634-637.

  15. Silapunt S, Peterson S R, Goldberg L H, Friedman P M, Alam M. Basal cell carcinoma on the vermilion lip: a study of 18 cases. J Am Acad Dermatol 2004; 50: 384-387.

  16. Loh T, Rubin A G, Brian Jiang S I. Management of mucosal basal cell carcinoma of the lip: an update and comprehensive review of the literature. Dermatol Surg 2016; 42: 1313-1319.

  17. Yaghoobi R, Ranjbari N, Pazyar N, Foroozan M, Feily A. Basal cell carcinoma of vermilion mucosa of upper lip: a rare case report. Acta Med Indones 2017; 49: 255-258.

  18. Hays J P, Malone C H, Tausend W E, Goodwin B P, Wagner R F Jr. Delayed diagnosis of basal cell carcinoma of the upper lip: the possible role of incidental multinucleated foreign body giant cells. Case Rep Dermatol 2017; 9: 50-54.

  19. Batalla A, Encinas-Muñiz A I, Gutiérrez-González E, de la Mano D. Photoletter to the editor: basal cell carcinoma on the vermilion lip. J Dermatol Case Rep 2015; 9: 25-26.

  20. Kelly D E, Klein K M, Harrigan W F. Lip reconstruction following resection for an unusual basal-cell carcinoma. Oral Surg Oral Med Oral Pathol 1975; 40: 19-26.

  21. White S W, Davis R A, Rodman O G. Surgical management of basal-cell carcinoma of the lower lip. J Dermatol Surg Oncol 1980; 6: 751-754.

  22. Hume W J, Turner E P. Basal cell carcinoma of lip mucosa. Br J Oral Surg 1982; 20: 248-255.

  23. Oriba H A, Sandermann S, Kircik L, Snow S N. Basal cell carcinoma of the vermilion zone of the lower lip: a report of 3 cases. Oral Oncol 1998; 34: 309-312.

  24. Dika E, Fanti P A, Ismaili A, Misciali C, Vaccari S, Patrizi A. Does BCC of the vermilion lip originate from the ectopic sebaceous glands? An observation in Mohs surgery. Eur J Dermatol 2012; 22: 706-707.

  25. Lee J, Russell M A. Basal cell carcinoma arising at the site of a lip piercing. Dermatol Surg 2019; 45: 149-151.

  26. Weitzner S, Hentel W. Multicentric basal-cell carcinoma of vermilion mucosa and skin of lower lip. Report of a case. Oral Surg Oral Med Oral Pathol 1968; 26: 269-272.

  27. Regan P A, Paine A, Travelute C R. Intraoral basal cell carcinoma discovered during mohs micrographic surgery. Dermatol Surg 2021; 47: 120-121.

  28. Keen R R, Elzay R P. Basal cell carcinoma from mucosal surface of lower lip: report of case. J Oral Surg Anesth Hosp Dent Serv 1964; 22: 453-455.

  29. Van der Wal K G, Mulder J W, Beetstra A. Basal-cell carcinoma of the vermilion border of the upper lip. A case report. Int J Oral Surg 1982; 11: 77-79.

  30. Mlika R B, Kerkeni N, Jebali A et al. Basal cell carcinoma of unusual site. Ann Pathol 2011; 31: 32-35.

  31. Ma X, Wang G, Kuwadekar A et al. Granular cell basal cell carcinoma: a case report. J Cutan Pathol 2018; 45: 223-225.

  32. Santana-Gutiérrez A, Guerrero-Putz M D, Vázquez-Martínez O, Ocampo-Candiani J. Basal cell carcinoma in the mucosa of the lower lip: a rare location. Dermatol Surg 2023; 49: 893-894.

  33. Rowe D, Gallagher R P, Warshawski L, Carruthers A. Females vastly outnumber males in basal cell carcinoma of the upper lip. A peculiar subset of high risk young females is described. J Dermatol Surg Oncol 1994; 20: 754-756.

  34. Woods T R, Cohen D M, Islam M N et al. Intraoral basal cell carcinoma, a rare neoplasm: report of three new cases with literature review. Head Neck Pathol 2014; 8: 339-348.

  35. Del Rosario R N, Barr R J, Jensen J L, Cantos K A. Basal cell carcinoma of the buccal mucosa. Am J Dermatopathol 2001; 23: 203-205.

  36. Kusafuka K, Kubota A, Suzuki M. Intraoral basal cell carcinoma of the soft palate: a diagnostic pitfall. Pathol Int 2022; 72: 433-435.

  37. Shumway B S, Kalmar J R, Allen C M, Rawal Y B. Basal cell carcinoma of the buccal mucosa in a patient with nevoid basal cell carcinoma syndrome. Int J Surg Pathol 2011; 19: 348-354.

  38. Schafer D R, Glass S H. A guide to yellow oral mucosal entities: etiology and pathology. Head Neck Pathol 2019; 13: 33-46.

  39. Daley T. Pathology of intraoral sebaceous glands. J Oral Pathol Med 1993; 22: 241-245.

  40. Belknap A N, Islam M N, Bhattacharyya I, Cohen D M, Fitzpatrick S G. Oral verruciform xanthoma: a series of 212 cases and review of the literature. Head Neck Pathol 2020; 14: 742-748.

  41. Santos H-B, Rolim L-S, Barros C-C, Cavalcante I-L, Freitas R-D, Souza L-B. Dermoid and epidermoid cysts of the oral cavity: a 48-year retrospective study with focus on clinical and morphological features and review of main topics. Med Oral Patol Oral Cir Bucal 2020; DOI: 10.4317/medoral.23388.

  42. Yang X, Ow A, Zhang C-P et al. Clinical analysis of 120 cases of intraoral lymphoepithelial cyst. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113: 448-452.

  43. Manor E, Sion-Vardy N, Joshua B Z, Bodner L. Oral lipoma: analysis of 58 new cases and review of the literature. Ann Diagn Pathol 2011; 15: 257-261.

  44. Alotaiby F M, Fitzpatrick S, Upadhyaya J, Islam M N, Cohen D, Bhattacharyya I. Demographic, clinical and histopathological features of oral neural neoplasms: a retrospective study. Head Neck Pathol 2019; 13: 208-214.

  45. Gouvêa A F, Ribeiro A C, León J E, Carlos R, de Almeida O P, Lopes M A. Head and neck amyloidosis: clinicopathological features and immunohistochemical analysis of 14 cases. J Oral Pathol Med 2012; 41: 178-185.

  46. Thompson L D R, Bauer J L, Chiosea S et al. Canalicular adenoma: a clinicopathologic and immunohistochemical analysis of 67 cases with a review of the literature. Head Neck Pathol 2015; 9: 181-195.

  47. Bonilla X, Parmentier L, King B et al. Genomic analysis identifies new drivers and progression pathways in skin basal cell carcinoma. Nat Genet 2016; 48: 398-406.

  48. Roda Â, Oliveira A. An unexpected shade of yellow. Dermatol Pract Concept 2021; DOI: 10.5826/dpc.1103a52.

  49. Navarrete-Dechent C, Liopyris K, Rishpon A et al. Association of multiple aggregated yellow-white globules with nonpigmented basal cell carcinoma. JAMA Dermatol 2020; 156: 882-890.

  50. Cameron M C, Lee E, Hibler B P et al. Basal cell carcinoma: contemporary approaches to diagnosis, treatment, and prevention. J Am Acad Dermatol 2019; 80: 321-339.

Download references

Acknowledgements

The authors would like to thank Jeff Comber in Information and Instructional Technology Services, Faculty of Dentistry, University of Toronto, for his assistance in the preparation of the figures.

Author information

Authors and Affiliations

  1. Oral Pathology and Oral Medicine, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada

    Justin Bubola & Grace Bradley

  2. Oral Pathology and Oral Medicine, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Department of Dentistry, Mount Sinai Hospital, Toronto, Canada

    Nadia Marchese & Deepika Chugh

  3. Oral Pathology and Oral Medicine, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Department of Dentistry, Mount Sinai Hospital, Toronto, Canada; Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada; Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada

    Iona Leong

  4. Oral Pathology and Oral Medicine, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Department of Dental and Maxillofacial Sciences, Sunnybrook Health Sciences Centre, Toronto, ON, Canada

    Marco Magalhaes

Authors
  1. Justin Bubola
    View author publications

    Search author on:PubMed Google Scholar

  2. Nadia Marchese
    View author publications

    Search author on:PubMed Google Scholar

  3. Iona Leong
    View author publications

    Search author on:PubMed Google Scholar

  4. Grace Bradley
    View author publications

    Search author on:PubMed Google Scholar

  5. Deepika Chugh
    View author publications

    Search author on:PubMed Google Scholar

  6. Marco Magalhaes
    View author publications

    Search author on:PubMed Google Scholar

Contributions

JB, NM, and DC conceptualized the study and designed the article. MM wrote the proposal for approval. JB performed the literature search and wrote the initial manuscript. IL, GB, and MM reviewed the results and critically appraised the manuscript.

Corresponding author

Correspondence to Justin Bubola.

Ethics declarations

The authors declare no conflicts of interest. This study was approved by the Research Ethics Board of the University of Toronto (Protocol #47899). Written consent for publication was obtained from patients.

Supplementary Information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bubola, J., Marchese, N., Leong, I. et al. Basal cell carcinomas of the lips: a case series and review of the literature. Br Dent J 238, 925–930 (2025). https://doi.org/10.1038/s41415-025-8509-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41415-025-8509-6

Search

Advanced search

Quick links