Perineural spread of cutaneous malignancy to the brain

Abstract

BACKGROUNDThe retrospective analysis was performed to investigate the role of stereotactic radiotherapy (SRT) techniques for patients with intracranial perineural spread (PNS) of a primary cutaneous malignancy.METHODSFive patients were identified who received SRT from 1993 to 2003 for cutaneous malignancies with intracranial PNS to the cavernous sinus (n = 3) or Meckel's cave (n = 2). Patients were treated with GammaKnife stereotactic radiosurgery (n = 2), linear accelerator (linac)‐based fractionated SRT (n = 2), or linac‐based stereotactic radiosurgery (n = 1).RESULTSThe median overall survival (OS) periods from diagnoses of cutaneous malignancy and intracranial PNS were 63.0 months (range, 22.0–102.2 months) and 25.5 months (range, 22.0–55.2 months), respectively. The median OS from SRT was 24.2 months (range, 19.5–53.2 months). One patient was alive and without evidence of disease at 53 months of follow‐up. The median durations of local and regional control from SRT were 19.5 months (range, 1.5–53.2 months) and 7.0 months (range, 1.5–53.2 months), respectively.CONCLUSIONSPrevious reports generally have recommended that patients with intracranial PNS receive palliative external‐beam radiotherapy. Results from the current study suggest that some of these patients may have prolonged survival, or even may be cured. Judicious use of SRT should be considered in their management. Cancer 2005. © 2005 American Cancer Society.

Imaging of cranial nerves: a pictorial overview

“…Two types of perineural growth of tumor are described: perineural invasion (PNI), a microscopical process that affect small nerves, and perineural spread of tumor (PNS) that extends along the sheaths covering larger central nerves [15]. The incidence of perineural spread is about 2.5–5% and may occur with any head and neck malignancy [16, 17]. It is typically associated with carcinoma arising from minor or major salivary glands (e.g., adenoid cystic carcinoma), mucosal or cutaneous squamous cell carcinoma, basal cell carcinoma, melanoma, lymphoma, and sarcoma.…”

Brain metastases: Comparing clinical radiological differences in patients with lung and breast cancers treated with surgery

“…Most BMs occur in the cerebrum (around 80 %), 42 followed by the cerebellum and brainstem, 43 with an overall distribution of metastases in correspondence of the cerebral gray–white junction, 5 primarily in the territory of the middle cerebral artery (MCA) and posterior cerebral artery (PCA). 44 , 45 , 46 , 47 …”

Intracranial squamous cell carcinoma arising in a cerebellopontine angle epidermoid cyst

“…Most squamous cell carcinomas involve the brain as a manifestation of metastases primarily originating from elsewhere in the body or as a result of direct invasion from head and neck cancer. [ 47 , 48 ] Malignant transformation of an epidermoid cyst is extremely rare, but it has been well documented since Ernst [ 4 ] first reported a case in 1912.…”