Article

Perineural invasion detected by high-field 3.0-T magnetic resonance imaging.

Division Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
American journal of otolaryngology (impact factor: 0.77). 08/2009; 31(6):482-4. DOI:10.1016/j.amjoto.2009.07.004 pp.482-4
Source: PubMed

ABSTRACT The presence of perineural invasion (PNI) with cutaneous squamous cell carcinoma portends a poor prognosis. PNI may be detected radiographically or clinically, with motor or sensory deficits, and is confirmed by histologic evaluation. Recent interest has grown regarding the role of imaging in determining the presence of PNI and its preoperative implications. We report on a patient with cutaneous squamous cell carcinoma invading the parotid gland with clinical evidence of facial nerve weakness. On standard 1.5 Tesla (T) magnetic resonance imaging (MRI), bilateral parotid glands were symmetric; however, a second high-field 3-T MRI revealed asymmetric enhancement of the left facial nerve at the stylomastoid foramen and extending throughout the left parotid gland. PNI was later confirmed on histopathology. The presurgical determination of PNI was essential in our mapping the exact tumor location and in our surgical planning.

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Keywords

asymmetric enhancement
 
bilateral parotid glands
 
clinical evidence
 
cutaneous squamous cell carcinoma
 
exact tumor location
 
histologic evaluation
 
left facial nerve
 
left parotid gland
 
parotid gland
 
perineural invasion
 
poor prognosis
 
preoperative implications
 
second high-field 3-T MRI
 
sensory deficits
 
standard 1.5 Tesla
 
stylomastoid foramen
 
surgical planning