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A Model for Perineural Invasion in Head and Neck Squamous Cell Carcinoma
Published on: January 5, 2017
Perineural invasion: identification, significance, and a standardized definition
Martin Dunn1, Michael B Morgan, Trevor W Beer
1Skin Cancer Specialist Inc., Sarasota, Florida, USA. mjdunnmd@hotmail.com
Summary
Mohs surgeons must identify perineural invasion (PNI), a cancer complication often leading to recurrence. This review clarifies PNI diagnosis and significance for Mohs surgery.
Area of Science:
- Dermatology
- Surgical Oncology
- Pathology
Background:
- Mohs surgery is increasingly used for diverse cancers.
- Accurate diagnosis of perineural invasion (PNI) is crucial for Mohs surgeons.
- PNI involves cancer cells invading nerves, impacting treatment and prognosis.
Observation:
- Perineural invasion (PNI) is a significant complication across various cancer types.
- Cancer recurrence is the most common consequence of PNI.
- Leptomeningeal carcinomatosis can arise from neglected or aggressive cancers.
Findings:
- PNI is characterized by an indolent, contiguous spread, suitable for Mohs surgery.
- Diagnostic mimics of PNI exist, potentially leading to inconsistent diagnostic criteria.
- Reported incidences and cure rates for PNI vary, highlighting diagnostic challenges.
Implications:
- Standardized histopathologic criteria for PNI diagnosis are proposed.
- Clear diagnostic guidelines are needed to improve PNI identification and management.
- Effective PNI diagnosis enhances Mohs surgery outcomes and patient prognosis.
