Perineural tumor spread
Perineural tumor spread is a form of metastatic disease in which primary tumors cells spread along the tissues of the nerve sheath, being a well recognized phenomenon in head and neck cancers.
Perineural tumor spread is more frequently associated with 1,2,5:
- mucosal/cutaneous squamous cell carcinoma
- oral cavity / laryngeal (2-30%) > cutaneous (3-8%)
- most common overall 5
- salivary gland carcinoma
- mucosal/cutaneous basal cell carcinoma (2-5% demonstrate perineural tumor spread) 4
Perineural tumor spread could be characterized as nerve thickening, widening of the neural foramen, loss of the fat surrounding the nerve and enhancement of the nerve after contrast administration.