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Carcinoma of the skin of the head and neck with perineural invasion
Author(s) -
Mendenhall William M.,
Amdur Robert J.,
Williams Lorna Sohn,
Mancuso Anthony A.,
Stringer Scott P.,
Mendenhall Nancy Price
Publication year - 2002
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.10025
Background Perineural invasion is observed in a small subset of patients with carcinomas of the skin of the head and neck. Methods Review of the patient literature highlighting the University of Florida experience. Results Patients with early perineural invasion are asymptomatic, and the phenomenon is discovered only on pathologic examination of the excised lesion. These patients are defined as having “incidental” perineural invasion, and treatment with surgery followed by postoperative irradiation results in a cure rate of approximately 80%. Undiagnosed, the perineural carcinoma slowly progresses and eventually results in symptoms, usually facial weakness or numbness. The disease eventually extends to the skull base and becomes incompletely resectable. Symptomatic patients are defined as having “clinical” perineural invasion, and aggressive treatment results in a cure rate of approximately 45%. Conclusions Perineural invasion is an uncommon spread pattern observed in patients with skin cancer and is associated with a relatively poor prognosis. The likelihood of cure is inversely related to the proximal extent of the cancer and is lower for symptomatic compared with asymptomatic patients. © 2002 John Wiley & Sons, Inc. Head Neck 24: 78–83, 2002.

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