Squamous cell carcinoma of the face with neurotropic spreading

Background and objective. Invasion of squamous cell carcinoma of the head and neck into cutaneous nerves is rare and can easily be missed. Perineural outgrowth into cerebral nerves may result in severe pain or neurological disturbances. In addition, these carcinomas more often recur or metastasize and therefore are associated with a poor prognosis. Patients/Methods. We report on two patients with squamous cell carcinoma of the dorsum of the nose and lower lip exhibiting neurotropic growth. Results. Histology showed pleomorphic keratinocytes growing deep into the subcutaneous tissue and bone, respectively.The presence of few pleomorphic keratinocytes could be only confirmed by immunohistochemistry, though indicated by a perineural lymphocytic infiltrate. In both patients, several re-excisions were necessary to achieve cure. Conclusions. In neurotropic squamous cell carcinoma a consequent radical micrographic surgery as well as neurological and radiological investigations are mandatory We also review the literature.