Perineural Tumor Extension of Facial Malignant Melanoma

Majoie, Charles B. L. M.; Hulsmans, Frans-Jan H.; Castelijns, Jonas A.; Walter, A.; Bras, Johan; Peeters, F. L. M.

doi:10.1097/00004728-199311000-00023

Cited by 15 publications

(13 citation statements)

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“…Cutaneous malignancies which are well known to exhibit neurotropism include SCC, 1,2 BCC, 2-4 and melanoma. 5,6 Although there is no universally accepted definition, spread of the malignancy to any of the 3 layers of the nerve sheath (epi-, peri-, and endoneurium) may be termed PNI or perineural spread. 9,10 PNI of cutaneous malignancies was first described pathologically more than 170 years ago.…”

Section: Discussionmentioning

confidence: 99%

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Contralateral Cranial Polyneuropathy Due to Perineural Invasion by a Cutaneous Squamous Cell Carcinoma

Sundaram

Simmons

Towfighi³

et al. 2010

Journal of Clinical Neuromuscular Disease

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Cutaneous malignancies may spread to underlying nerves, a process known as perineural invasion (PNI). We report a patient who was found to have PNI presenting as a cranial polyneuropathy on the contralateral side of the face many years after the resection of a squamous cell carcinoma. All diagnostic testing was unrevealing until nerve biopsy was performed. This emphasizes the long asymptomatic period between treatment of a cutaneous malignancy and detection of PNI, and the development of PNI at a site distant from the original malignancy. Biopsy of a clinically involved nerve may permit diagnosis of PNI when other studies are normal.

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Section: Discussionmentioning

confidence: 99%

“…Specific recommendations for optimal imaging of PNI by MRI have been published. 6,18,20,25,32,36 Computed tomography scan of the base of the skull is useful for foraminal or neural canal erosions. 19,32,33,37 Denervation atrophy of muscles may seen radiographically.…”

Section: Discussionmentioning

confidence: 99%

Contralateral Cranial Polyneuropathy Due to Perineural Invasion by a Cutaneous Squamous Cell Carcinoma

Sundaram

Simmons

Towfighi³

et al. 2010

Journal of Clinical Neuromuscular Disease

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“…If neural invasion has occurred, the possibility of cure may exist as long as the extension of the NTM is recognized and adequately resected prior to entry into the cranial vault [22]. Based on the imaging study, surgery was expanded in our patient in order to remove as much tumor bulk as possible but irresectability was confirmed due to tumor extension into the PPF (case 13, published previously: [23]). …”

Section: Other Tumor Typesmentioning

confidence: 97%

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

Majoie

Hulsmans

Verbeeten

et al. 1997

European Journal of Radiology

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General rightsIt is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulationsIf you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: http://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. AbstractObjectice: To evaluate the magnetic resonance imaging (MRI) findings of 15 patients with perineural tumor extension along the trigeminal nerve in correlation with clinical data. ,~Iethods: The clinical records and MRI studies of 15 patients with perineura.l tumor extension along the trigeminal nerve were retrospectively reviewed. Imaging studies included plain and contrast-enhanced thin section Tl-weighted spin echo (T1-WSE) MRI with and without fat-suppression. The studies were compared to determine which sequence provided greatest tumor conspicuity and best depiction of tumor extent. The conspicuity of these tumors was assessed on the available sequences by two observers by consensus. Results: The contrast-enhanced Tl-weighted spin echo fat-suppressed images (TI-WSECEFS) demonstrated greatest tumor conspicuity and best depiction of tumor extent in the extracranial head and neck and skull base region. The conventional Tl-weighted spin echo pre-and postcontrast images were, however, diagnostic of perineural tumor extension in 11 patients due to the presence of considerable tumor bulk and extension well above the skull base. In the other four patients the perineural tumor was poorly visualized on the conventional TI-WSE images and well visualized on the fat-suppressed images. The mandibular division of the trigeminal nerve (V3) was most commonly involved (n = 10), followed by the maxillary. (V2; n = 5) and ophthalmic (VI; n = 2) division. Two patients had both mandibular as well as maxillary nerve involvement. The finding of perineural tumor extension had significant impact on patient management: based on the MR imaging study, the primary tumor was considered inoperable (n = 13), the extent of surgery was expanded (n = 2) and radiation therapy (RT) ports were extended (n = 12). Conclusion: Complete trigeminal nerve imaging is recommended when evaluating (suspected) head and neck malignancies with a high risk for perineural extension. In these cases thin section axial and coronal precontrast T1-WSE MR images and postcontrast TI-WSE MR images with fat-suppression should be obtained. In the rare event that artifacts degrade the quality of the fat-suppressed images, contrast-enhanced TI-WSE sequences without fat...

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“…The numerous anastomoses between the fibers of these two nerves explain the frequent cross-metastatization [21]. The numerous anastomoses between the fibers of these two nerves explain the frequent cross-metastatization [21].…”

Section: • Perineurial Diffusionmentioning

confidence: 99%

“…In select cases direct visualization of soft tissue cords along the course of the nerve may be possible [19,21,[96][97][98] (Fig. The neural invasion may in turn result in atrophy of the corresponding muscle groups.…”

Section: Head and Neck Regionmentioning

confidence: 99%