title: Neurotropic cutaneous tumors of the head and neck.
abstract: OBJECTIVE
  To determine the outcomes of patients with neurotropic cutaneous tumors of the head and neck.
  
  
  METHODS
  A retrospective review was conducted of 7852 charts of patients who underwent micrographically controlled excisions of skin cancers of the head and neck between 1984 and 1995, identifying neurotropic tumors and the outcomes of their treatments.
  
  
  METHODS
  Tertiary care center (university hospital).
  
  
  METHODS
  Thirty-seven patients with neurotropic tumors were identified (and confirmed by secondary histological review), constituting 0.47% of all patients. The median age at presentation was 68 years and all except an albino were white. Nine patients had basal cell carcinomas and 28 had squamous cell carcinomas. Twenty-five patients (69%) were referred after at least 1 prior excision was performed a median of 16 months previously.
  
  
  METHODS
  All patients underwent micrographic mapping and excision of the cutaneous portion of the tumor. As necessitated by tumor spread, additional soft tissue, skull base, and/or intracranial surgery and postoperative irradiation were also conducted.
  
  
  METHODS
  Thirty-four patients (3 patients were unavailable for follow-up) were assessed by physician examination a minimum of 19 months after treatment (median, 33 months).
  
  
  RESULTS
  Of 25 patients with extracranial disease only, 19 had no evidence of disease during follow-up and 1 died of intercurrent disease at 20 months without evidence of tumor persistence. Of the 9 patients with intracranial neurotropic tumors at the time of presentation, 1 remained with no evidence of disease, 1 died of intercurrent disease at 21 months without evidence of tumor persistence, and the other 7 either died of or are living with an intracranial tumor.
  
  
  CONCLUSIONS
  Micrographic tissue mapping to detect and then encompass neurotropic cutaneous malignancies, along with conventional surgery for deeper tumor invasions and irradiation in selected cases, was successful in 19 patients (76%) with an extracranial tumor. For those with neurotropic tumors approaching or penetrating the skull base, the prognosis was poor regardless of therapy method.
authors.affiliation: Department of Otolaryngology, Medical University of South Carolina, Charleston, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Osguthorpe
authors.forename: C G
authors.initials: CG
authors.lastname: Abel
authors.forename: P
authors.initials: P
authors.lastname: Lang
authors.forename: M
authors.initials: M
authors.lastname: Hochman
mesh_terms: D000368:Aged; D002280:Basal Cell Carcinoma / Q000473:pathology* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D015580:Mohs Surgery; D009361:Neoplasm Invasiveness; D010525:Peripheral Nerves / Q000473:pathology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome