Contralateral cranial polyneuropathy due to perineural invasion by a cutaneous squamous cell carcinoma.
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.
Sundaram
Arun N E
AN
Department of Neurology, Penn State College of Medicine, Hershey Medical Center, Hershey, PA 17033, USA.
Simmons
Zachary
Z
Towfighi
Javad
J
Sheehan
Jonas
J
Reichwein
Raymond
R
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*
D007633:Keratins