title: Perineural spread in head and neck tumors.
abstract: Perineural spread is the dissemination of some types of head and neck tumors along nervous structures. Perineural spread has negative repercussions on treatment because it requires more extensive resection and larger fields of irradiation. Moreover, perineural spread is associated with increased local recurrence, and it is considered an independent indicator of poor prognosis in the TNM classification for tumor staging. However, perineural spread often goes undetected on imaging studies. In this update, we review the concept of perineural spread, its pathogenesis, and the main pathways and connections among the facial nerves, which are essential to understand this process. Furthermore, we discuss the appropriate techniques for imaging studies, and we describe and illustrate the typical imaging signs that help identify perineural spread on CT and MRI. Finally, we discuss the differential diagnosis with other entities.
authors.affiliation: Radiodiagnóstico. Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España. Electronic address: beatrizbreaalvarez@yahoo.es.
authors.forename: B
authors.initials: B
authors.lastname: Brea Álvarez
authors.affiliation: Radiodiagnóstico. Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Tuñón Gómez
mesh_terms: D003390:Cranial Nerve Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D009361:Neoplasm Invasiveness
keywords: Computed tomography; Cranial nerve neoplasms/diagnosis; Cranial nerve neoplasms/secondary; Head and neck neoplasms/diagnosis; Head and neck neoplasms/secondary; Imagen Multimodal; Magnetic resonance imaging; MeSh Terms; Metástasis; Multimodal imaging; Neoplasias Cabeza y Cuello/ Diagnóstico; Neoplasm invasiveness; Neoplasm metastasis; RM; TC; Tumores Nervios Craneales/Diagnóstico; Tumores Nervios Craneales/Secundarios; X-Ray