The Dissemination of Tumors of the Head and Neck via the Cranial Nerves

Neural cell adhesion molecules (N-CAMs) are expressed in neuromuscular tissues, neuroblastoma, and small cell lung carcinoma. Adenoid cystic carcinoma may invade the skull by either direct extension or neural involvement, particularly along the second and third divisions of the trigeminal nerve (V2 and V3). Eighteen patients with adenoid cystic carcinoma that invaded the skull base were studied. The tumors were graded into predominantly solid (3), cribriform (11), or tubular-trabecular (4) patterns, and neural involvement was evaluated histologically. Paraffin sections were examined by use of monoclonal antibodies for N-CAM and Ki-67, a proliferation marker, with the avidin-biotin-peroxidase method. Fifteen (83%) tumors showed perineural involvement; in the remaining three cases no nerves were present for histologic examination. Fourteen (93%) of 15 tumors with perineural involvement were reactive with N-CAM. Proliferation, measured by the presence of nuclear Ki-67, was markedly increased in tumors with predominantly solid patterns. We demonstrated that N-CAM is expressed in adenoid cystic carcinoma. The role of N-CAM as a neurodeterminant that facilitates the spread of adenoid cystic carcinoma along nerves, however, remains unanswered and warrants further study.

Section: Discussionmentioning

confidence: 99%

Neural Cell Adhesion Molecule in Adenoid Cystic Carcinoma Invading the Skull Base

Gandour‐Edwards

Kapadia

Barnes

et al. 1997

“…MRI signs of perineural spread include tumor mass isointense to muscle and smooth thickening of the nerve. However, imaging is not always helpful, especially at the early stage of the spread 8,10,14. Although some patients show perineural spread in excised specimens, some do not 12.…”

Section: Discussionmentioning

confidence: 99%

“…The second most commonly involved cranial nerve is the facial nerve 1. This is probably through the abundant fine anastomoses with the trigeminal nerve in the face,7,8 as well as through a major anastomosis from the chorda tympani branch of the facial to the lingual branch of the mandibular division of the trigeminal nerve 3. Perineural spread along the facial nerve might also be the result of direct invasion of the facial muscles.…”

Section: Discussionmentioning

confidence: 99%

Perineural Spread of Facial Squamous Cell Carcinoma to the Vestibulocochlear Nerve

Murofushi

Pohl

Hálmagyi

1997

Perineural spread of facial squamous cell carcinoma (SCC) is a well-recognized cause of trigeminal and of facial nerve palsies. 1 Vestibulocochlear nerve involvement by perineural spread has not been convincingly demonstrated. Here we report a patient with perineural spread of facial SCC not only to the trigeminal and facial nerves but also to the ipsilateral vestibulocochlear nerve. The anatomic and pathophysiologic basis of this spread is discussed.

“…He also noted that numbness within a nerve's distribution is almost pathognomonic for invasion; however, burning, stinging, or shooting pains may likewise indicate nerve invasion. Dodd, 3 in 1970, outlined the role of plain film radiography in establishing the diagnosis of cranial nerve infiltration by cancer. Since then, however, contemporary imaging studies have revolutionized our ability to diagnose patients with perineural invasion.…”

Section: Figurementioning

confidence: 99%

Perineural extension to the skull base from early cutaneous malignancies of the midface

Padhya

Cornelius

Athavale

et al. 2007