Perineural extension to the skull base from early cutaneous malignancies of the midface.
OBJECTIVE
To document the clinical progression of four patients with a past history of complete removal of early midface cutaneous malignancies that presented years later with isolated recurrence along the distribution of the infraorbital nerve, and to discuss the diagnostic role of early imaging to identify perineural invasion.


METHODS
The study is a retrospective chart review, review of radiographic findings, and review of the literature.


RESULTS
The authors report four cases of isolated perineural invasion along the infraorbital nerve resulting from previously excised cutaneous malignancies.


CONCLUSIONS
Pain followed by anesthesia in the distribution of second division of the trigeminal nerve should alert the practitioner about possible perineural recurrence that may require imaging and open exploration to establish the diagnosis.
Padhya
Tapan A
TA
Department of Otolaryngology-Head and Neck Surgery, University of South Florida College of Medicine, Tampa, FL 33612, USA.
Cornelius
Rebecca S
RS
Athavale
Sanjay M
SM
Gluckman
Jack L
JL
D000328:Adult; D000368:Aged; D018450:Disease Progression; D005153:Facial Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness / Q000473:pathology; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D019291:Skull Base / Q000473:pathology; D019292:Skull Base Neoplasms / Q000175:diagnosis / Q000473:pathology*; D014276:Trigeminal Nerve