Carcinoma of the skin of the head and neck with perineural invasion

被引:102
作者
Mendenhall, WM
Amdur, RJ
Williams, LS
Mancuso, AA
Stringer, SP
Mendenhall, NP
机构
[1] Univ Florida, Hlth Sci Ctr, Dept Radiat Oncol, Gainesville, FL 32610 USA
[2] Univ Florida, Hlth Sci Ctr, Dept Radiol, Gainesville, FL USA
[3] Univ Florida, Hlth Sci Ctr, Dept Otolaryngol, Gainesville, FL USA
来源
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK | 2002年 / 24卷 / 01期
关键词
D O I
10.1002/hed.10025
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
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. (C) 2002 John Wiley & Sons, Inc.
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页码:78 / 83
页数:6
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