medigraphic.com

2004, Number 2

<< Back Next >>

Anales de Radiología México 2004; 3 (2)

Perineural tumor dissemination in head and neck

Valdivieso CGE, Avila FF, Vázquez LJ, Navarro BRG, Couto AF

Language: Spanish
References: 20
Page: 83-90
PDF size: 356.02 Kb.


ABSTRACT

Perineural dissemination (PD) is a very important finding in the evaluation of malignant head and neck neoplasms. It usually implies tumoral non-resectability and must be differentiated from other oncologic clinical situations with neurological manifestations. The clinical alterations can be sensitive or motor and the most frequently affected nerves are the facial and trigeminal nerves. Changes in imaging studies, especially in Magnetic Resonance Imaging are more sensitive than the clinical findings. For these reasons the role of the Radiologist is key in the diagnosis of this disease and implies knowing the related neuroanatomy.
High risk sites for PD are the pterigomaxillary fossae, parotid gland, masticator space, orbital fissures, skull base foramina, cavernous sinus and Meckel´s cave. Some of these areas have a predominantly adipose content, while Meckel´s cave has a similar appearance to CSF, which is shown in the normal imaging studies.
The signs in Magnetic Resonance Imaging are alterations of the normal signal characteristics of the region, as well as increase in nerve size and enhancement. Computed Tomography is less sensitive in the detection of these changes; nonetheless, it shows alterations in the cortical area of the foramina.
The objectives of this article are: review the characteristics of perineural dissemination of head and neck neoplasms, with emphasis in the decisive role of the Radiologist. Analyze the appearance with Magnetic Resonance Imaging and Computed Tomography, and to present some representative cases of each type of lesion.


REFERENCES

  1. Som Peter M, Curtin HD. Head and Neck Imaging Fourth Edition. Mosby 866-885.

  2. Batsakis JG. Pathology consultation: Nerves and neurotropic carcinomas. Ann Otol Rhinol Laryngol 1985;94:426-427

  3. Soo KC, Carter RL, O’Brien CJ, et al. Prognostic implications of perineural spread of squamous carcinomas of the head and neck. Laryngoscope 1986;96: 1145-1148.

  4. Ginsberg LE. Imaging of perineural tumor spread in head and neck cancer. Seminars Ultrasound CT and MR 1999;2:175-186.

  5. Woddruff WW, Yeates AE, McLendon RE. Perineural tumor extension to the cavernous sinus from superficial facial carcinoma: CT manifestations. Radiology 1986;161:395-399

  6. McLean FM, Ginsberg LE, et al. Perineural spread of rhinocerebral mucormycosis. AJNR 1996;17: 114-116.

  7. Bailey BJ, Calhoun KH. Head and neck surgery. Otolaryngology Second Edition. Lippincott-Williams and Wilkins. Capítulo 103: Neoplasms of the nose and paranasal sinuses.

  8. Pauwels LW, Akesson EJ. Cranial nerves in healt and disease. Second Edition London 2002. BC Decker Inc.

  9. Ginsberg LE, Pruett SW, Chen MY, et al. Skull-base foramina of the middle cranial fossa: reassessment of normal variation with high-resolution CT. AJNR 1994;15: 283-291

  10. Matzko J, Becker DG, et al. Obliteration of fat planes by perineural spread of sqamous cell carcinoma along the inferior alveolar nerve. AJNR 1994;15: 1843-1845.

  11. Laine FJ, Braun IF et al. Perineural tumor extension through the foramen ovale: evaluation with MR imaging. Radiology 1990;174:65-71.

  12. Russo CP, Smoker WRK, et al. MR appearance of trigeminal and hypoglossal motor denervation. AJNR 1997;18:1375-1383.

  13. Davis SB, Mathews VP, Williams DW. Masticator muscle enhancement i subacute denervation atrophy. AJNR 1995;16:1292-1294.

  14. Ginsberg LE, DeMonte F. Imaging of perineural tumor spread from palatal carcinoma. AJNR 1998;19:1417-1422

  15. Curtin HD, Williams R, Johnson J. CT of perineural tumor extension: pterygopalatine fossa. AJNR 1984;5:731-737.

  16. Parker GD, Harnsberger HR. Clinical-radiologic isues in perineural tumor spread of malignant diseases of the extracranial head and neck. Radiographics 1991;11: 383-399.

  17. Barakos JA, Dillon WP, et al. Orbit, skullbase, anf pharynx: contrast-enhanced fat suppression MR imaging. Radiology 1991;179:191-198

  18. Ginsberg LE, De Monte F, Guillenwater AM. Greater superficial petrosal nerve: anatomy and MR findings in perineural tumor spread. AJNR 1996;17:389-393.

  19. Ginsberg LE, Eicher SA. Great auricular nerve: anatomy and imaging of perineural tumor spread. AJNR 2000;21:568-571

  20. Curtin HD. Detection of perineural spread: fat is a friend. Editorial. AJNR 1998;19:1385-1386.




2020     |     www.medigraphic.com