title: Contralateral cranial polyneuropathy due to perineural invasion by a cutaneous squamous cell carcinoma.
abstract: Cutaneous malignancies may spread to underlying nerves, a process known as perineural invasion (PNI). We report a patient who was found to have PNI presenting as a cranial polyneuropathy on the contralateral side of the face many years after the resection of a squamous cell carcinoma. All diagnostic testing was unrevealing until nerve biopsy was performed. This emphasizes the long asymptomatic period between treatment of a cutaneous malignancy and detection of PNI, and the development of PNI at a site distant from the original malignancy. Biopsy of a clinically involved nerve may permit diagnosis of PNI when other studies are normal.
authors.affiliation: Department of Neurology, Penn State College of Medicine, Hershey Medical Center, Hershey, PA 17033, USA.
authors.forename: Arun N E
authors.initials: AN
authors.lastname: Sundaram
authors.forename: Zachary
authors.initials: Z
authors.lastname: Simmons
authors.forename: Javad
authors.initials: J
authors.lastname: Towfighi
authors.forename: Jonas
authors.initials: J
authors.lastname: Sheehan
authors.forename: Raymond
authors.initials: R
authors.lastname: Reichwein
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D003390:Cranial Nerve Neoplasms / Q000378:metabolism / Q000473:pathology / Q000556:secondary*; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D007633:Keratins / Q000378:metabolism; D008297:Male; D012878:Skin Neoplasms / Q000473:pathology*
chemical_list: D007633:Keratins