Histopathological features of clinical perineural invasion of cutaneous squamous cell carcinoma of the head and neck and the potential implications for treatment

Panizza, Benedict; Warren, Timothy A.; Solares, C. Arturo; Boyle, Glen M.; Lambie, Duncan; Brown, Ian

doi:10.1002/hed.23509

Cited by 49 publications

(65 citation statements)

References 60 publications

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“…(27) Several studies have used a single immunostain to enhance nerve detection and thus Either way, it is considered most likely that in cases of clinical perineural spread it is the intraneural involvement that causes the characteristic symptoms and signs. (20) In the aforementioned study, only 3.9% of specimens demonstrated epineural involvement, which is thought to reflect the multilayer barrier function of the perineurium beyond the superficial fascia, effectively limiting tumour cell migration beyond the nerve compartment into surrounding soft issue. The perineurium thus provides an adequate resection margin when tumour is confined to the nerve macroscopically.…”

Section: Histopathological Features Of Perineural Growthmentioning

confidence: 88%

“…(20) However, encasement of more than 33% of the nerve circumference or tumour cells within any layer of the neural sheath is considered highly suggestive, if not diagnostic, of PNI. (21) This form of perineural involvement is not evident on clinical or radiological examination and is established by microscopy.…”

Section: Defining Perineural Growthmentioning

confidence: 99%

“…(23,24) However, we consider this likely to represent tissue-sectioning artefact, with a recent histopathological review of 49 patients treated with surgery at our institution demonstrating no evidence of noncontiguous spread in 50 separate cases. (20) Magnetic resonance (MR) neurography detects 95%…”

Section: Defining Perineural Growthmentioning

confidence: 99%

“…(20,27) There is also likely variation in awareness levels and rates of detection across different geographical regions. PNI occurs in 2.5% to 14% of cases of cSCC, with most studies reporting rates < 5%.…”

Section: Epidemiology Of Perineural Growthmentioning

confidence: 99%

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Molecular mechanisms of perineural spread of cutaneous carcinoma: a potential role for receptor tyrosine kinases and other biomarkers

Schmidt¹

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Perineural invasion and spread of cutaneous squamous cell carcinoma of the head and neck (cSCCHN) is associated with worse prognosis and high rates of locoregional recurrence. It occurs in less than 5% of cases, but given the high incidence of cSCC in Australia, portends significant morbidity and mortality. Primary tumour biology remains poorly understood and precise molecular mechanisms by which malignant squamous cells invade and progress axially within the perineural space remain unclear. Thus, there is no targeted therapy for perineural spread of cSCCHN or other neurotropic malignancies. Dysregulation of cell membrane receptor trafficking is a hallmark of cancer and such receptors are potential therapeutic targets.Over-expression of the epidermal growth factor receptor (EGFR) is well described in squamous cell carcinoma and the monoclonal antibody cetuximab is approved for advanced mucosal head Ultimately, we aim to improve survival and quality of life for sufferers of this morbid form of tumour spread. Our findings may also have implications for other neurotropic malignancy, including pancreatic, gastric, colorectal and prostate cancers. 4 Declaration by authorThis thesis is composed of my original work, and contains no material previously published or written by another person except where due reference has been made in the text. I have clearly stated the contribution by others to jointly-authored works that I have included in my thesis.

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Section: Histopathological Features Of Perineural Growthmentioning

confidence: 88%

Section: Defining Perineural Growthmentioning

confidence: 99%

Section: Defining Perineural Growthmentioning

confidence: 99%

Section: Epidemiology Of Perineural Growthmentioning

confidence: 99%

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Molecular mechanisms of perineural spread of cutaneous carcinoma: a potential role for receptor tyrosine kinases and other biomarkers

Schmidt¹

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“…In rare cases of lymphoma, an intravascular tumor spread may occur, 33 or CN infiltration may result in neurolymphomatosis. 34,35 In squamous cell carcinomas of Review the head and neck, the tumor spread is usually contiguous; skip lesions do not seem to occur, 36 as they do in parotid tumors. 20 In rare cases of primary brain tumors, continuous nerve infiltration can occur in the cavernous sinus, 37 along the CNs, and continuously into the bone and surrounding tissue.…”

Section: Mechanisms Of Nerve Invasionmentioning

confidence: 99%

Cancer around the brain

Grisold

2014

Neuro-Oncology Practice

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Background Neuro-oncologists are familiar with primary brain tumors, intracerebral metastases meningeal carcinomatosis and extracerebral intracranial tumors as meningeoma. For these conditions, and also some other rare tumor entities several treatment options exist. Cancer can also involve structures around the brain as the dura, the base of the skull, the cavities of the skull and tissue around the bony skull, the skin, the tissue of the neck. and either compress, invade or spread in the central or peripheral nervous system. Methods A systematic literature research was conducted determining symptoms and signs, tumor sites of nerve invasion, tumor types, diagnostic techniques, mechanisms of nerve invasion, and important differential diagnosis. Additional cases from own experience were added for illustration. Results The mechanisms of tumor invasion of cranial nerves is heterogenous and not only involves several types of invasion, but also spread along the cranial nerves in antero- and retrograde fashion and even spread into different nerve territories via anastomosis. In addition the concept of angiosomas may have an influence on the spread of metastases. Conclusion In addition to the well described tumor spread in meningeal carcinomatosis and base of the skull metastases, dural spread, lesions of the bony skull, the cavities of the skull and skin of the face and tissue of the neck region need to be considered, and have an impact on therapeutic decisions.

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

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157

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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Histopathological features of clinical perineural invasion of cutaneous squamous cell carcinoma of the head and neck and the potential implications for treatment

Cited by 49 publications

References 60 publications

Molecular mechanisms of perineural spread of cutaneous carcinoma: a potential role for receptor tyrosine kinases and other biomarkers

Molecular mechanisms of perineural spread of cutaneous carcinoma: a potential role for receptor tyrosine kinases and other biomarkers

Cancer around the brain

ICAR: endoscopic skull‐base surgery

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