title: Patterns of perineural tumor spread in head and neck cancer.
abstract: Perineural tumor spread (PNS) is a mode of neoplastic spread whereby tumor cells use neural conduits to escape the borders of a primary tumor. MRI is generally favored over CT for evaluating PNS, and findings include obliteration of fat within skull base foramina, enlargement and enhancement of the involved nerves, and enlargement and destruction of the bony foramina. Careful examination of the entire course of the nerve allows detection of skip lesions. Recognition of the complete extent of PNS is crucial for correct treatment because it facilitates both surgical and radiotherapy targeting of entire extent of disease.
authors.affiliation: Department of Radiology, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA 02114, USA. gmoonis@bidmc.harvard.edu
authors.forename: Gul
authors.initials: G
authors.lastname: Moonis
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Cunnane
authors.forename: Kevin
authors.initials: K
authors.lastname: Emerick
authors.forename: Hugh
authors.initials: H
authors.lastname: Curtin
mesh_terms: D003287:Contrast Media; D003390:Cranial Nerve Neoplasms / Q000556:secondary*; D003937:Diagnosis, Differential; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009361:Neoplasm Invasiveness; D018317:Nerve Sheath Neoplasms / Q000556:secondary*; D009417:Nerve Tissue / Q000473:pathology*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media