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2022, Number 3

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Dermatología Cosmética, Médica y Quirúrgica 2022; 20 (3)

Perineural invasion in cutaneous tumors

Díaz PLLA, Miller A, García RCA

Language: Spanish
References: 24
Page: 334-338
PDF size: 123.25 Kb.


ABSTRACT

Perineural invasion (PNI) represents the presence of neoplastic cells surrounding nerves, involving all its covering layers. This phenomenon is usually an incidental finding of cutaneous malignancies affecting head and neck, and usually represents a prognostic indicator of poor outcome. There are known risks factors, including immunosuppression, radiation exposure, aggressive histologic subtype, diameter and topographical anatomy. Most patients are asymptomatic or have non-specific symptoms like numbing or tingling; severe cases develop pain, paresthesia or motor neurological deficits. The incidence of PNI in basal cell carcinoma is 0.18-3%, in squamous cell carcinoma 2-5-5.95%, increasing to 14% in recurrent tumors. In microcystic adnexal carcinoma PNI is found in 59%. Histopathological diagnosis can be difficult in routine sections; Mohs micrographic surgery allows full examination of the margins and it’s consider the technique of choice, since it has shown to be superior compared to standard excision.


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