Perineural tumor extension along the trigeminal nerve: magnetic resonance imaging findings

Majoie, Charles B. L. M.; Hulsmans, Frans-Jan H.; Verbeeten, B.; Castelyns, Jonas A.; Oldenburger, Foppe; Schouwenburg, Paul F.; Bosch, Dirk

doi:10.1016/s0720-048x(96)01122-9

Cited by 42 publications

(45 citation statements)

References 25 publications

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“…Contrastenhanced T1-weighted spin-echo images with fat-suppression are often most helpful for diagnosis (8). As with other tumors that demonstrate perineural spread, principle MR features include abnormal nerve thickening with enhancement after contrast, concentric expansion and/or erosion of skull base foramina and extracranial bony nerve canals, enhancing mass in Meckel's cave, lateral bulging of the cavernous sinus dura, and denervation atrophy of innervated muscles such as the masticator muscles.…”

Section: Discussionmentioning

confidence: 99%

“…Imaging included sagittal, axial, and coronal T1-weighted images, axial fast spin-echo T2-weighted images with fat saturation, and axial and coronal T1-weighted images postgadolinium with fat saturation. Images were assessed qualitatively for evidence of perineural spread of tumor on the basis of criteria described by multiple authors (6,8,10). In brief, these features included abnormal nerve thickening and/or contrast enhancement, expansion and/or erosion of skull base foramina, enhancing mass in Meckel's cave, lateral bulging of the cavernous sinus dura, and denervation atrophy of the muscles of mastication.…”

Section: Methodsmentioning

confidence: 99%

“…Perineural spread of malignant melanoma of the head and neck has been reported (8,9) but is considered rare. Our purpose is to present eight patients with perineural spread of head and neck melanoma and discuss the pertinent clinical and diagnostic imaging features.…”

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confidence: 99%

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Perineural spread of malignant melanoma of the head and neck: clinical and imaging features

Chang¹,

Fischbein²,

McCalmont³

et al. 2004

American Journal of Ophthalmology

105

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BACKGROUND AND PURPOSE:Extension of malignant melanoma along cranial nerves is a little-known complication of malignant melanoma of the head and neck. We describe the clinical and MR imaging findings of perineural spread of malignant melanoma to cranial nerves, emphasizing that this entity occurs more commonly with desmoplastic histology and may have a long latent period following primary diagnosis.METHODS: At two institutions, we identified and retrospectively reviewed eight cases of malignant melanoma of the head and neck that had MR imaging evidence of perineural spread of disease. All patients underwent confirmatory tissue sampling.RESULTS: Seven patients had melanomas of the facial skin or lip, and one patient had a primary sinonasal lesion. By histopathology, these melanomas included five desmoplastic, two mucosal, and one poorly differentiated melanotic spindle-cell tumor. All patients developed symptomatic cranial neuropathy an average of 4.9 years from the time of initial diagnosis. MR imaging demonstrated postgadolinium enhancement of at least one branch of the trigeminal nerve in all cases and of at least one other cranial nerve in five cases. Other findings included abnormal contrast enhancement and soft tissue thickening in the cavernous sinus, Meckel's cave, and/or the cisternal segment of the trigeminal nerve.CONCLUSION: Although perineural spread of disease occurs most commonly with squamous cell carcinoma and adenoid cystic carcinoma, malignant melanoma must also be included in this differential diagnosis, particularly if the patient's pathology is known to be desmoplastic. Similarly, any patient with malignant melanoma of the head and neck who undergoes MR imaging should receive an imaging assessment focused on the likely routes of perineural spread.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Perineural spread of malignant melanoma of the head and neck: clinical and imaging features

Chang¹,

Fischbein²,

McCalmont³

et al. 2004

American Journal of Ophthalmology

105

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“…Trigeminal neuralgia involving all three divisions of the nerve is the most common primary symptom of a Meckel's cave neoplasm [5][6][7], but clinical findings do not allow accurate localization of the lesion [8]. Therefore, the entire course of the trigeminal nerve must be visualized from the brainstem origin to the peripheral endplates.…”

Section: Discussionmentioning

confidence: 99%

Metastases in Meckel's Cave

et al. 2007

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Metastases in Meckel's cave are a rare tumor entity and should be considered as important differential diagnosis, especially if the patient presents with trigeminal neuralgia and suffers from a known primary malignancy. We present three cases of patients with secondary trigeminal neuralgia caused by a metastasis in Meckel's cave, treated by microsurgery and fractionated radiation therapy. Differential diagnoses are discussed on the basis of preoperative neuroradiological imaging. MRI is the preferred diagnostic modality, whereas complementary CT may be needed for evaluation of early bone invasion. ZusammenfassungDas Cavum Meckeli ist ein seltener Manifestationsort tumoraler Metastasen. Bei Patienten mit bekannter maligner Tumorerkrankung, die unter einer Trigeminusneuralgie leiden, sollte jedoch die Metastasierung des Cavum Meckeli in differentialdiagnostische Betrachtungen einbezogen werden. Wir präsentieren drei Fälle mit sekundärer Trigeminusneuralgie infolge Metastasierung des Cavum Meckeli. Alle drei Patienten wurden mittels Mikroneurochirurgie und fraktionierter Radiotherapie behandelt. Die Magnetresonanztomographie ist die Methode der Wahl in der Evaluation neuroradiologischer Differentialdiagnosen. Die Computertomographie ist sehr hilfreich zur Beurteilung knöcherner Arrosionen.

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“…Thin-section post Gadolinium T1 imaging is the most sensitive technique to demonstrate perineural tumour spread, presence of which usually worsens the prognosis and may preclude cure if unrecognised. 4,5 Diffusion-weighted imaging at the skull base remains technically challenging due to artefact and distortion from the bone air interface, which can be reduced by employing a non-echoplanar sequence. Although reliable threshold values are difficult to define, malignant tumours tend to display lower diffusivity than benign disease with the exception of certain non-neoplastic lesions such as epidermoid cysts and cholesteatoma, which are known for their characteristic diffusion restriction.…”

Section: Introductionmentioning

confidence: 99%

Imaging of skull base tumours

Thust

Yousry

2016

Reports of Practical Oncology & Radiotherapy

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Skull base imagingHead and neck Skull base tumours Oncology a b s t r a c tThe skull base is a highly complex and difficult to access anatomical region, which constitutes a relatively common site for neoplasms. Imaging plays a central role in establishing the differential diagnosis, to determine the anatomic tumour spread and for operative planning. All skull base imaging should be performed using thin-section multiplanar imaging, whereby CT and MRI can be considered complimentary. An interdisciplinary team approach is central to improve the outcome of these challenging tumours.

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Perineural tumor extension along the trigeminal nerve: magnetic resonance imaging findings

Cited by 42 publications

References 25 publications

Perineural spread of malignant melanoma of the head and neck: clinical and imaging features

Perineural spread of malignant melanoma of the head and neck: clinical and imaging features

Metastases in Meckel's Cave

Imaging of skull base tumours

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