Journal of the American Academy of Dermatology
Volume 62, Issue 2 , Pages 270-276 , February 2010

Perineural invasion progressing to leptomeningeal carcinomatosis: Is the absence of peripheral nerves an important sign?

  • Martin Dunn, MD

      Affiliations

    • Skin Cancer Specialist, Inc, Sarasota, Florida
    • Corresponding Author InformationReprint requests: Martin Dunn MD, 5575 Marquesas Circle, Sarasota, FL 34233.
  • ,
  • Michael B. Morgan, MD

      Affiliations

    • University of South Florida College of Medicine and James Haley Veterans Hospital, Bay Area Dermatopathology, Ameripath, Tampa, Florida

References 

  1. Kokkoris CP. Leptomeningeal carcinomatosis. How does cancer reach the pia-arachnoid?. Cancer. 1983;51:154–160
  2. Maroldi R, Ambrosi C, Farina D. Metastatic disease of the brain: extra-axial metastases (skull, dura, leptomeningeal) and tumor spread. Eur Radiol. 2005;15:617–626
  3. Niazi ZBM, Lamberti BGH. Perineural infiltration in basal cell carcinomas. Br J Plast Surg. 1993;46:156–157
  4. Ratner D, Lowe L, Johnson TM, Fader DJ. Perineural spread of basal cell carcinomas treated with Mohs micrographic surgery. Cancer. 2000;88:1605–1613
  5. Mohs FE, Lathrop TG. Modes of spread of cancer of the skin. AMA Arch Dermatol Syphilol. 1952;66:427–439
  6. Limawararut V, Leibovitch I, Sullivan T, Selva D. Periocular squamous cell carcinoma. Clin Exp Ophthalmol. 2007;35:174–185
  7. Leibovitch I, Huilgol SC, Selva D, Lun K, Richards S, Paver R. Microcystic adnexal carcinoma: treatment with Mohs micrographic surgery. J Am Acad Dermatol. 2005;52:295–300
  8. Kaplan AL, Weitzul SB, Taylor RS. Longitudinal diminution of tumor size for basal cell carcinoma suggests shifting referral patterns for Mohs surgery. Dermatol Surg. 2007;34:15–19
  9. Dodd GD, Dolan PA, Ballantyne AJ, Ibanez ML, Chau P. The dissemination of tumors of the head and neck via the cranial nerves. Radiol Clin North Am. 1970;8:445–461
  10. Ebenezer GJ, McArthur JC, Thomas D, Murinson B, Hauer P, Polydefkis M, et al. Denervation of skin in neuropathies: the sequence of axonal and Schwann cell changes in skin biopsies. Brain. 2007;130:2703–2714
  11. Lawrence N, Cottel WI. Squamous cell carcinoma of the skin with perineural invasion. J Am Acad Dermatol. 1994;31:30–33
  12. Han A, Ratner D. What is the role of adjuvant radiotherapy in the treatment of cutaneous squamous cell carcinoma with perineural invasion?. Cancer. 2007;109:1053–1059
  13. Takubo K, Takai A, Yamashita K, Yoshimatsu N, Kitano M, Sasajima K, et al. Light and electron microscopic studies of perineural invasion by esophageal carcinoma. J Natl Cancer Inst. 1985;74:987–993
  14. Anderson C, Krutchkoff D, Ludwig M. Carcinoma of the lower lip with perineural extension to the middle cranial fossa. Oral Surg Oral Med Oral Pathol. 1990;69:614–618
  15. Osguthorpe JD, Abel CG, Lang P, Hochman M. Neurotropic cutaneous tumors of the head and neck. Arch Otolaryngol Head Neck Surg. 1997;123:871–876
  16. Scurry WC, Isaacson JE, Fedok FG. New-onset facial paralysis and undiagnosed recurrence of cutaneous malignancy: evaluation and management. Am J Otolaryngol. 2006;27:139–142
  17. Selesnick SH, Burt BM. Regional spread of nonneurogenic tumors to the skull base via the facial nerve. Otol Neurotol. 2003;24:326–333
  18. Nelson BR, Goldberg LH. Facial nerve palsy as a result of squamous cell carcinoma of the skin. J Dermatol Surg Oncol. 1989;15:510–513
  19. Newlin HE, Morris CG, Amdur RJ, Mendenhall WM. Neurotropic melanoma of the head and neck with clinical perineural invasion. Am J Clin Oncol. 2005;28:399–402
  20. Trobe JD, Hood CI, Parsons JT, Quisling RG. Intracranial spread of squamous carcinoma along the trigeminal nerve. Arch Ophthalmol. 1982;100:608–611
  21. Pena YM, Bason MM, Grant-Kels JM. Basosquamous cell carcinoma with leptomeningeal carcinomatosis. Arch Dermatol. 1990;126:195–198
  22. Mickalites CJ, Rappaport I. Perineural invasion by squamous cell carcinoma of the lower lip. Oral Surg Oral Med Oral Pathol. 1978;46:74–78
  23. Bhatnagar AK, Heron DE, Schaitkin B. Perineural invasion of squamous cell carcinoma of the lip with occult involvement of the infra-orbital nerve detected by PET-CT and treated with MRI-based IMRT: a case report. Technol Cancer Res Treat. 2005;4:251–253
  24. Sullivan LM, Smee R. Leptomeningeal carcinomatosis from perineural invasion of a lip squamous cell carcinoma. Australas Radiol. 2006;50:262–266
  25. Begemann M, Rosenblum MK, Loh J, Kraus D, Razier JJ. Leptomeningeal metastases from recurrent squamous cell cancer of the skin. J Neurooncol. 2003;63:295–298
  26. Padhya TA, Cornelius RS, Athavale SM, Gluckman JL. Perineural extension to the skull base from early cutaneous malignancies of the midface. Otolaryngol Head Neck Surg. 2007;137:742–746
  27. Chang DT, Mancuso AA, Riggs CE, Mendenhall WM. Merkel cell carcinoma of the skin with leptomeningeal metastases. Am J Otolaryngol. 2005;26:210–213
  28. Reyes N, Terron C, Martinez E, Zabala JA, Larrondo J. [Progressive cranial neuropathy due to perineural spread of a facial squamous cell carcinoma.] Spanish. Neurologia. 2003;18:112–115
  29. Veness MJ, Biankin S. Perineural spread leading to orbital invasion from skin cancer. Australas Radiol. 2000;44:296–302
  30. DiGregorio C, Florena AM, Gebbia V, Moschella F. Mental nerve invasion by basal cell carcinoma of the chin: a case report. Anticancer Res. 1998;18:4723–4726
  31. Schifter M, Barrett AP. Perineural spread of squamous cell carcinoma involving trigeminal and facial nerves. Oral Surg Oral Med Oral Pathol. 1993;75:587–590
  32. Eng CT, Vasconez LO. Facial pain due to perineural invasion by basal cell carcinoma. Ann Plast Surg. 1984;12:374–377
  33. Mark GJ. Basal cell carcinoma with intraneural invasion. Cancer. 1977;40:2181–2187
  34. Lee KJ, Abemayor E, Sayre J, Bhuta S, Kirsch C. Determination of perineural invasion preoperatively on radiographic images. Otolaryngol-Head and Neck Surg. 2008;139:275–280
  35. Maroldi R, Farina D, Borghesi A, Marconi A, Gatti E. Perineural tumor spread. Neuroimaging Clin North Am. 2008;18:413–429
  36. Ojiri H. Perineural spread in head and neck malignancies. Radiat Med. 2006;24:1–8
  37. Gandhi D, Gujar S, Mukherji S. Magnetic resonance imaging of perineural spread of head and neck malignancies. Top Magn Reson Imaging. 2004;15:79–85
  38. Ballantyne AJ, McCarten AB, Ibanez ML. The extension of cancer of the head and neck through peripheral nerves. Am J Surg. 1963;106:651–667
  39. Omdal R, Mellgren SI, Goransson L, Skjesol A, Lindal S, Koldingsnes W, et al. Small nerve fiber involvement in systemic lupus erythematosus: a controlled study. Arthritis Rheum. 2002;46:1228–1232
  40. Pan CL, Tseng TJ, Lin YH, Chiang MC, Lin WM, Hsieh ST. Cutaneous innervations in Guillain-Barre syndrome: pathology and clinical correlations. Brain. 2003;126:386–397
  41. Polydefkis M, Yiannoutsos CT, Cohen BA, Hollander H, Schifitto G, Clifford DB, et al. Reduced intraepidermal nerve fiber density in HIV-associated sensory neuropathy. Neurology. 2002;58:115–119
  42. Smith GA, Ramachandran P, Tripp S, Singleton RJ. Epidermal nerve innervations in impaired glucose tolerance and diabetes-associated neuropathy. Neurology. 2001;57:1701–1704
  43. Carter RL, Foster CJ, Dinsdale EA, Pittam MR. Perineural spread by squamous cell carcinoma of the head and neck: a morphological study using antiaxonal and antimyelin monoclonal antibodies. J Clin Pathol. 1983;36:269–275
  44. Soo KC, Carter RL, O'Brien CJ, Barr L, Bliss JM, Shaw HJ. Prognostic implications of perineural spread in squamous cell carcinoma of the head and neck. Laryngoscope. 1986;96:1145–1148
  45. Birkby CS, Whitaker DC. Management considerations for cutaneous neurophilic tumors. J Dermatol Surg Oncol. 1988;14:731–737
  46. Matorin PA, Wagner RF. Mohs micrographic surgery: technical difficulties posed by perineural invasion. Int J Dermatol. 1992;31:83–86

 Funding sources: None.

 Conflicts of interest: None declared.

PII: S0190-9622(09)00939-6

doi: 10.1016/j.jaad.2009.06.083

Journal of the American Academy of Dermatology
Volume 62, Issue 2 , Pages 270-276 , February 2010