Michael Eric Stone MD, Presenter: Nothing to Disclose

Brent David Griffith MD, Abstract Co-Author: Nothing to Disclose

Suresh C. Patel MD, Abstract Co-Author: Nothing to Disclose

Perineural spread (PNS) is a well-recognized entity involving cancers of the head and neck, which has important diagnostic, prognostic, and treatment implications. Because the clinical presentation of PNS is often nonspecific, the radiologist plays an important role in patient work-up and staging. The purpose of this exhibit is to discuss: 1. Clinical implications of PNS, including impact on patient prognosis and treatment. 2. Common routes for PNS in the head and neck, including normal skull base and cranial nerve (CN) anatomy. 3. Imaging findings in PNS, including role of CT and MRI.  

I. Etiologies and Implications of PNS a. Malignancies most commonly implicated in PNS, including adenoid cystic and squamous cell carcinoma, as well as potential mimics of PNS. b. Impact of PNS on staging, prognosis, and treatment. II. Imaging of PNS in the Head and Neck a. Strengths and weakness of CT and MRI. b. Normal skull base and CN anatomy, including skull base foramina, as well as course and branches of the most commonly involved CN’s (e.g., CN V and CN VII). c. Imaging findings of perineural spread, including: foraminal enlargement or destruction, nerve enlargement/enhancement, loss of perineural fat, muscle atrophy. d. Case review emphasizing “do not miss” findings of PNS that all radiologists should be aware of.  

http://abstract.rsna.org/uploads/2014/14000484/14000484_88aj.pdf

Stone, M, Griffith, B, Patel, S, You’re Getting on My Nerves – Imaging of Perineural Spread in Head and Neck Cancer.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000484.html