Management Considerations for Cutaneous Neurophilic Tumors

Birkby, Craig S.; Whitaker, Duane C.

doi:10.1111/j.1524-4725.1988.tb01157.x

Cited by 27 publications

(51 citation statements)

References 23 publications

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“…Skip areas have been postulated as an explanation for false-negative surgical margins by several authors. 13,[43][44][45] Although most false-negative margins may be explained by less than perfect processing of Mohs surgical specimens, 46 Wallerian degeneration as postulated in this case could cause the loss of small peripheral nerve axons, resulting in noncontiguous perineural invasion.…”

Section: Discussionmentioning

confidence: 80%

Perineural invasion progressing to leptomeningeal carcinomatosis: Is the absence of peripheral nerves an important sign?

Dunn

Morgan

2010

Journal of the American Academy of Dermatology

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Section: Discussionmentioning

confidence: 80%

Perineural invasion progressing to leptomeningeal carcinomatosis: Is the absence of peripheral nerves an important sign?

Dunn

Morgan

2010

Journal of the American Academy of Dermatology

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“…Therefore, when tumors invade nerves, Mohs surgery has its limitation in identifying perineural invasion conclusively due to possible false “skip areas” or the so-called “discontinuous perineural extension.” Nevertheless, Mohs surgery, by examining 100% of the surgical margin utilizing horizontal sections, still has increased sensitivity as compared to routine histological processing, in which equivalent to 0.01% of the specimen surface area is evaluated [30, 31]. As perineural inflammation and “skip areas” due to tissue processing may indicate proximal perineural invasion, some authors advocate the removal of an additional Mohs layer after tumor-free margins are obtained [32, 33]. We would like to share our experience in managing cutaneous malignancies with perineural invasion in general.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Adenoid Cystic Carcinoma with Perineural Invasion Treated by Mohs Micrographic Surgery—A Case Report with Literature Review

Hinshaw

Longley

et al. 2010

Journal of Oncology

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We report a 58-year-old woman with cutaneous adenoid cystic carcinoma arising on the chest treated with Mohs micrographic surgery. The patient remained tumor-free at 24-month follow-up. To date, only six other cases of cutaneous adenoid cystic carcinoma were reportedly managed by Mohs surgery. Cutaneous adenoid cystic carcinoma has low potential for distant metastasis but is notorious for its aggressive infiltrative growth pattern, frequent perineural invasion, and high risk of local recurrence after excision. We propose that Mohs surgery is an ideal method to achieve margin-free removal of cutaneous adenoid cystic carcinoma. A brief literature review is provided.

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“…7 Cutaneous tumors with perineural invasion are generally associated with increased aggressiveness, extensive soft-tissue spread, and an increased incidence of recurrence, and increased morbidity and mortality. [8][9][10][11][12][13][14][15] This underscores the need for a consistent diagnostic criteria of perineural involvement (PNI). Dunn et al 16 defined PNI as the presence of cytologically malignant cells observed in the perineural space of nerves.…”

Section: Introductionmentioning

confidence: 99%

Perineural Involvement: What Does it Mean?

Ronaghy

Yaar²,

Goldberg³

et al. 2010

The American Journal of Dermatopathology

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Perineural invasion is an important mechanism for local spread in certain malignant cutaneous neoplasms and is associated with aggressive tumor growth, increased frequency of recurrence, and increased morbidity and mortality. Thus, perineural invasion is often used both as a marker of malignancy and an indicator of aggressive behavior. There exists, however, a limited number of cutaneous and noncutaneous benign neoplasms in addition to reactive lesions that either demonstrates perineural involvement or mimics it. Given the association of the term "invasion" with malignant neoplasms, we use the term "perineural involvement" to describe neoplastic cells of any type infiltrating within nerves. Despite the presence of perineural involvement in these benign lesions, there is no evidence of aggressive behavior compared with similar examples which do not demonstrate perineural involvement. The aim of this article is to review cutaneous and noncutaneous benign neoplasms and reactive conditions that may demonstrate or mimic perineural involvement. Recognition of the spectrum of benign processes that may resemble perineural involvement may help prevent diagnostic confusion, misdiagnosis, and overly aggressive treatment.

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Management Considerations for Cutaneous Neurophilic Tumors

Abstract: The proper management of patients with neurophilic skin cancers is often quite difficult. When present, neurophilic invasion significantly worsens the prognosis. Important considerations for managing patients with cutaneous neurophilic tumors and illustrative cases are presented.

Cited by 27 publications

References 23 publications

Perineural invasion progressing to leptomeningeal carcinomatosis: Is the absence of peripheral nerves an important sign?

Perineural invasion progressing to leptomeningeal carcinomatosis: Is the absence of peripheral nerves an important sign?

Cutaneous Adenoid Cystic Carcinoma with Perineural Invasion Treated by Mohs Micrographic Surgery—A Case Report with Literature Review

Perineural Involvement: What Does it Mean?

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