Panizza Benedict, Warren Timothy A, Solares C Arturo, Boyle Glen M, Lambie Duncan, Brown Ian
Department of Otolaryngology, Head and Neck Surgery and Queensland Skull Base Unit, Princess Alexandra Hospital, Brisbane, Queensland, Australia; School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Head Neck. 2014 Nov;36(11):1611-8. doi: 10.1002/hed.23509. Epub 2013 Dec 18.
Nonmelanoma skin cancer (NMSC) with perineural invasion (PNI) is most commonly seen in cutaneous squamous cell carcinoma of the head and neck (SCCHN). The cranial nerves are a conduit for skin cancer to reach the brainstem.
The histopathological features of 51 tissue specimens from 49 patients with cutaneous SCCHN and clinical PNI were assessed with consecutive transverse and longitudinal sections.
No skip lesions were identified. Tumor spread was contiguous in all specimens. No tumor spread into the perineural space from surrounding or adjacent tumor was seen. Proximal large cranial nerves showed epineural involvement in 3.9% in areas with large tumor bulk, extensive PNI, and intraneural invasion.
Perineural tumor spread in cutaneous SCCHN was contiguous and no skip lesions were evident in nerve specimens assessed in this series. Spread beyond cranial nerve perineurium was uncommon, reflecting its multilayer barrier function at this level. These findings may have treatment implications.
伴有神经周围浸润（PNI）的非黑色素瘤皮肤癌（NMSC）最常见于头颈部皮肤鳞状细胞癌（SCCHN）。颅神经是皮肤癌到达脑干的一条途径。
对49例伴有临床PNI的皮肤SCCHN患者的51份组织标本进行连续横切和纵切，评估其组织病理学特征。
未发现跳跃性病变。所有标本中肿瘤均呈连续性扩散。未观察到肿瘤从周围或相邻肿瘤扩散至神经周围间隙。在肿瘤体积大、PNI广泛和神经内浸润的区域，近端大颅神经的神经外膜受累率为3.9%。
皮肤SCCHN中的神经周围肿瘤扩散是连续性的，在本系列评估的神经标本中未发现明显的跳跃性病变。超出颅神经神经束膜的扩散并不常见，这反映了其在此水平的多层屏障功能。这些发现可能对治疗有影响。
