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Revision 16 for 'Perineural spread of tumor'

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Perineural spread of tumor

Perineural spread of tumor is a form of local invasion in which primary tumors cells spread along the tissues of the nerve sheath.  It is a well-recognized phenomenon in head and neck cancers.

An important distinction has to be made between perineural invasion (PNI) and perineural spread (PNS). The former is a histological finding of tumor cell infiltration or associated with small nerves that cannot be radiologically imaged, while the latter is macroscopic tumor involvement along a nerve extending away from the primary tumor; this can be radiologically apparent.  A third term, neurotropism, simply means that a tumor has an affinity for growth along nerves.

Pathology

Perineural tumor spread is more frequently associated with 1,2,5:

Radiographic features

MRI

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 following contrast administration. 

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