Perineural infiltration in basal cell carcinomas

Niazi, Zainab; Lamberty, B.G.H.

doi:10.1016/0007-1226(93)90150-a

Cited by 58 publications

(46 citation statements)

References 9 publications

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“…On the basis of the best available literature, the most useful stratification of BCC is provided by the National Comprehensive Cancer Network (NCCN) Guidelines (for recommendation, see Table II; for level of evidence/strength of recommendation, see Table III). 2,3,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] The NCCN stratification, listed in Table IV, takes both clinical and pathologic parameters into account and is based on a combination of available evidence and expert multidisciplinary opinion, including representatives from dermatology, dermatopathology, head and neck surgery, plastic surgery, and surgical, radiation, and medical oncology. Treatment recommendations throughout the current guidelines are based on this stratification.…”

Section: Grading and Stagingmentioning

confidence: 99%

“…If deeper invasion cannot be ruled out, as in the case of tumor transection (ie, tumor extension to the base of the biopsy), this may be noted. The work group recommends including, when possible, details regarding the specific histologic subtype(s) detected, 17,19,26,28 invasion of the tumor beyond the reticular dermis, 17,19 and perineural invasion, 3,29,30 as these parameters provide prognostic information regarding the potential for recurrence (see Table VI; for level of evidence/strength of recommendations, see Table III).…”

Section: Clinical and Pathologic Informationmentioning

confidence: 99%

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Guidelines of care for the management of basal cell carcinoma

Baum¹,

Bordeaux²,

Brown³

et al. 2018

Journal of the American Academy of Dermatology

328

219

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Basal cell carcinoma (BCC) is the most common form of human cancer, with a continually increasing annual incidence in the United States. When diagnosed early, the majority of BCCs are readily treated with office-based therapy, which is highly curative. In these evidence-based guidelines of care, we provide recommendations for the management of patients with BCC, as well as an in-depth review of the best available literature in support of these recommendations. We discuss biopsy techniques for a clinically suspicious lesion and offer recommendations for the histopathologic interpretation of BCC. In the absence of a formal staging system, the best available stratification based on risk for recurrence is reviewed. With regard to treatment, we provide recommendations on treatment modalities along a broad therapeutic spectrum, ranging from topical agents and superficially destructive modalities to surgical techniques and systemic therapy. Finally, we review the available literature and provide recommendations on prevention and the most appropriate follow-up for patients in whom BCC has been diagnosed. ( J Am Acad Dermatol

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Section: Grading and Stagingmentioning

confidence: 99%

Section: Clinical and Pathologic Informationmentioning

confidence: 99%

Guidelines of care for the management of basal cell carcinoma

Baum¹,

Bordeaux²,

Brown³

et al. 2018

Journal of the American Academy of Dermatology

328

219

View full text Add to dashboard Cite

show abstract

“…On rare occasions, a lesion manifests tenderness or pain which can be a clue to perineural infiltration in the aggressive growth varieties. 17 Sensorimotor compromise has been reported particularly in lesions of the preauricular and cheek areas. 17 Metastases are rare and most are said to more closely correlate to the size and depth and less so to the histologic subtype of the original tumor.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…17 Sensorimotor compromise has been reported particularly in lesions of the preauricular and cheek areas. 17 Metastases are rare and most are said to more closely correlate to the size and depth and less so to the histologic subtype of the original tumor. [18][19][20] Lesions that recur after radiotherapy may infiltrate widely prior to becoming clinically apparent; this plus the fact that radiotherapy is often reserved for aggressive growth tumors ought to enhance the suspicion of perineural infiltration in recurrent BCC postirradiation.…”

Section: Clinical Featuresmentioning

confidence: 99%

Basal cell carcinoma: biology, morphology and clinical implications

2006

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Basal cell carcinoma (BCC) is the most common malignant neoplasm of humans. Rising dramatically in incidence in North America, as likely reflects changing habits of the population and a move from more northerly climes to the sunbelt of the Southern and Southwestern United States, the incidence is surely to rise even higher in the future. The last decade has seen significant advances in our understanding of BCC biology and novel approaches to therapy, which hinge upon accurate diagnosis and subclassification by pathologists. The purpose of this review article is to summate the research advances in our understanding of BCC biology and to acquaint pathologists and clinicians to the practical issues in BCC diagnosis and subclassification which flow there from.

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“…[22][23][24][25] Exenteration for sebaceous gland carcinoma is more likely to be required if there is intraepithelial (pagetoid) spread of the tumour. 26 Perineural invasion occurs in less than 1% of basal cell carcinomas, 18,27 but in about 3-14% of squamous cell carcinomas. 17,28 It is more common in lesions of the forehead and brow 29,30 and with aggressive cell types.…”

Section: Indicationsmentioning

confidence: 99%

Orbital exenteration for invasive skin tumours

Tyers

2006

Eye

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Orbital exenteration aims at local control of disease invading the orbit that is potentially fatal or relentlessly progressive. Of all exenterations presenting to ophthalmologists, 40-50% are required for tumours in the eyelid or periocular skin. 99% of these are basal cell carcinomas and 4-6% each are squamous cell carcinomas or sebaceous gland carcinomas. Orbital invasion results in progressive fixation of the tumour to bone and reduced ocular motility. Perineural invasion of branches of the trigeminal nerve leads to numbness or pain, and that the facial nerve, to weakness. Biopsy identifies the cell type and the presence of perineural invasion. CT and MRI scanning help in the assessment of tumour spread within the orbit. Management should be in collaboration with an oncologist. Exenteration may be totalthe removal of all orbital contents-or lidsparing if the tumour is placed posteriorly. The socket may be allowed to heal by granulation or lined with a split skin graft or local flap. Complications may be seen following 20-25% of exenterations and include fistulae, tissue necrosis, exposed bone, and infection. Incomplete clearance of tumours occurs in about 38% of total exenterations and 17% of subtotal. The overall 5-year survival is 55-65%, but significantly worse if there was perineural spread. Facial prostheses may be mounted on glasses or secured with tissue glue or osseointegrated implants. Excellent cosmetic results can be achieved but many patients prefer to wear a patch.

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Perineural infiltration in basal cell carcinomas

Cited by 58 publications

References 9 publications

Guidelines of care for the management of basal cell carcinoma

Guidelines of care for the management of basal cell carcinoma

Basal cell carcinoma: biology, morphology and clinical implications

Orbital exenteration for invasive skin tumours

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