Perineural Infiltration of Cutaneous Squamous Cell Carcinoma and Basal Cell Carcinoma Without Clinical Features

Cutaneous Squamous Cell Carcinoma with Perineural Invasion: Report on Eight Cases and Review of the Literature

“…Our cases follow the typical characteristics for SCC with PNI: older patients with recurrent and/or multiple incompletely excised SCCs (tables 1, 2) [2,8,9,10,11,12,13,14,15,16,17]. Most of our patients were 60 years or older, and an average of four excisions were necessary for complete removal.…”

“…Furthermore, Ross et al [22] described that the chance of metastasis increases with the diameter of the involved nerve (>0.09 mm). Lin et al [16] noted that nerves affected up to 1 mm did not affect survival, whereas infiltration of thicker nerves did. In our patients no clear association between thickness of infiltrated nerves and prognosis could be seen, probably due to the small number of patients.…”

Inferior outcomes in immunosuppressed patients with high-risk cutaneous squamous cell carcinoma of the head and neck treated with surgery and radiation therapy

“…30 PNI is also a known risk factor for recurrence and is quite common in immunosuppressed patients, comprising 50% of our patient cohort. 31,32 Although bimodality therapy has a long track record in high-risk cSCC-HN, patients who are immunosuppressed appear to have more aggressive biology and suboptimal outcomes. As a result, several important questions emerge: should postoperative RT be offered to immunosuppressed patients with earlier stage disease who would normally be observed after surgery, in the hopes of reducing the likelihood of developing recurrent disease?…”

Neurotrophin Receptors and Perineural Invasion

“…At least two studies have reported that in cSCC, PNI in nerves with a diameter >0.1 mm is associated with worse outcomes (metastasis and recurrence) while involvement of nerves <0.1 mm was not associated with negative outcomes (Carter, Johnson, Chua, Karia, & Schmults, 2013;Ross et al, 2009). However, Lin et al report that the diameter of the involved nerve had no impact on outcomes in cSCC (Lin et al, 2012). Additionally, Carter et al also report that the involvement of multiple nerves is associated with risk factors that portend worse outcomes when compared to solitary foci of PNI (Carter et al, 2013).…”

“…Additionally, Carter et al also report that the involvement of multiple nerves is associated with risk factors that portend worse outcomes when compared to solitary foci of PNI (Carter et al, 2013). While, Lin et al similarly found that patients with focal PNI had better outcomes than those who had diffuse PNI with multiple foci of invasion (Lin et al, 2012).…”