Abstract
A case of malignant cutaneous lesion of the face diagnosed initially as sebaceous carcinoma, subsequently proven to be squamous cell carcinoma is presented. Patient was initially evaluated at an outside institution by computed tomography, which indicated extension of lesion to the maxillary sinus. Patient underwent local resection. Further imaging by magnetic resonance imaging was done for recurrent tumour. Examination revealed extensive, large volume, perineural extension of the disease via infraorbital nerve to the cavernous sinus. Patient was managed with extensive lesion resection, including the skull base component followed up by radiation. Patient showed recurrence despite aggressive management. This case highlights the crucial role of performing an optimal MR imaging of the target region, including skull base, to exclude a perineural extension, as part of assessment of oro-facial malignancy.
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References
Terashi H, Kurata S, Tadokoro T, Ishii Y, Sato H, Kudo Y, Katagiri K, Itami S, Takayasu S (1997) Perineural and neural involvement in skin cancers. Dermatol Surg 23(4):259–264 discussion 264-5
Silbert PL, Kelsall GR, Shepherd JM, Gubbay SS (1992) Enigmatic trigeminal sensory neuropathy diagnosed by facial skin biopsy. Clin Exp Neurol 29:234–238
Fowler BZ, Crocker IR, Johnstone PA (2005) Perineural spread of cutaneous malignancy to the brain: a review of literature and five patients treated with stereotactic radiotherapy. Cancer 103:2143–2153
Ong CK, Chong VF-H (2010) Imaging of perineural spread in head and neck tumours. Cancer Imaging 10(1A):S92–S98. doi:10.1102/1470-7330.2010.9033
Williams LS, Mancuso AA, Mendenhall WM (2001) Perineural spread of cutaneous squamous and basal cell carcinoma: CT and MR detection and its impact on patient management and prognosis. Int J Radiat Oncol Biol Phys 49(4):1061–1069
Gandhi MR, Panizza B, Kennedy D (2011) Detecting and defining the anatomic extent of large nerve perineural spread of malignancy: comparing “targeted” MRI with the histologic findings following surgery. Head Neck 33(4):469–475. doi:10.1002/hed.21470
Williams LS (1999) Advanced concepts in the imaging of perineural spread of tumour to the trigeminal nerve. Top Magn Reson Imaging 10(6):376–383
Paes FM, Singer AD, Checkver AN, Palmquist RA, De La Vega G, Sidani C (2013) Perineural spread in head and neck malignancies: clinical significance and evaluation with 18F-FDG PET/CT. Radiographics 33(6):1717–1736. doi:10.1148/rg.336135501
Bradley A Schiff, Arlen D Meyers (ed) (2013) Perineural spread of tumor along the fifth and seventh cranial nerves. Medscape, http://emedicine.medscape.com/article/875786-overview, Accessed 10 Dec 2013
Acknowledgments
Authors sincerely acknowledge and thank the contributions of Dr. Bichu Jacob, Dr. Naveen Hadne for clinical contribution and Dr. Anita Borges for pathology review.
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Bhat, V., Devere, J., Ramakrishanan, A. et al. Perineural Spread in Squamous Cell Carcinoma of the Face: An Overlooked Facet of Information on Imaging. J. Maxillofac. Oral Surg. 15, 390–393 (2016). https://doi.org/10.1007/s12663-015-0788-z
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DOI: https://doi.org/10.1007/s12663-015-0788-z