Histopathological features of clinical perineural invasion of cutaneous squamous cell carcinoma of the head and neck and the potential implications for treatment

Benedict Panizza, Timothy A. Warren, C. Arturo Solares, Glen M. Boyle, Duncan Lambie, Ian Brown

Research output: Contribution to journalArticle

26 Scopus citations


Background 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. Methods The histopathological features of 51 tissue specimens from 49 patients with cutaneous SCCHN and clinical PNI were assessed with consecutive transverse and longitudinal sections. Results 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. Conclusion 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.

Original languageEnglish (US)
Pages (from-to)1611-1618
Number of pages8
JournalHead and Neck
Issue number11
Publication statusPublished - Nov 1 2014



  • head and neck neoplasms
  • perineurium
  • peripheral nerve neoplastic infiltration
  • skin cancer
  • squamous cell carcinoma

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this