Abstract
Perineural spread (PNS) represents the tumor’s ability to disseminate along nerves. The aim of this article is to review the relevant literature about the PNS in head-and-neck tumors. The important information for imaging analysis is summarized in a diagnostic flowchart. The pathogenesis, clinical signs, prognostic importance, and technical considerations for computer tomography and magnetic resonance imaging are briefly discussed. The anatomical pathways of the cranial nerves (CNs) and the main checkpoints are synthesized. Most commonly affected nerves are the trigeminal and facial, although any of the CNs may be involved. The described imaging features represent important clues for an optimal differential diagnosis. PNS worsens the prognosis and significantly changes the treatment, thus radiologists should be aware of this entity and be able to find it on imaging in the appropriate clinical context.
Highlights
Perineural spread (PNS) worsens the prognosis and significantly changes the treatment, radiologists should be aware of this entity and be able to find it on imaging in the appropriate clinical context
Head and neck malignancies comprise a considerable variety of histologic subtypes, the most common type being the squamous cell carcinoma (SCC)
The presence of PNS implies worsening of the prognosis and change in treatment and it may occur even in the absence of hematogenous or lymphatic metastasis [2]
Summary
Perineural spread in head and neck malignancies: imaging findings - an updated literature review.
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