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KEY FACTS
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Imaging
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TERMINOLOGY
Abbreviations
- Perineural tumor (PNT) of masticator space (MS) is malignant spread along CNV3 (mandibular branch of trigeminal nerve)
Synonyms
- PNT spread, PNT invasion
- Trigeminal ganglion = gasserian ganglion, semilunar ganglion
Definitions
- CNV3: 3rd division of trigeminal nerve (CNV)
- CNV3 PNT: Extension of malignancy along CNV3 allowing spread from MS though foramen ovale into Meckel cave (MC)
- MC: Small cistern for CNV
- Contains trigeminal ganglion in anterior aspect of MC
IMAGING
General Features
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Tsutsumi S et al: The emissary veins of the foramen ovale: an anatomical study using magnetic resonance imaging. Surg Radiol Anat. 42(7):771-7, 2020
- Agarwal M et al: Perineural tumor spread in head and neck malignancies. Semin Roentgenol. 54(3):258-75, 2019
- Bakst RL et al: Perineural invasion and perineural tumor spread in head and neck cancer. Int J Radiat Oncol Biol Phys. 103(5):1109-24, 2019
- Sipprell WH 3rd et al: Cranial neuropathies as the presenting symptom of cutaneous squamous cell carcinoma. JAAD Case Rep. 5(12):1037-40, 2019
- Dankbaar JW et al: Easily detected signs of perineural tumour spread in head and neck cancer. Insights Imaging. 9(6):1089-95, 2018
- Kirsch CFE et al: Practical tips for MR imaging of perineural tumor spread. Magn Reson Imaging Clin N Am. 26(1):85-100, 2018
- Malhotra A et al: Neuroimaging of Meckel's cave in normal and disease conditions. Insights Imaging. 9(4):499-510, 2018
- Badger D et al: Imaging of perineural spread in head and neck cancer. Radiol Clin North Am. 55(1):139-49, 2017
- Warren TA et al: The natural history and treatment outcomes of perineural spread of malignancy within the head and neck. J Neurol Surg B Skull Base. 77(2):107-12, 2016
- Singh FM et al: Patterns of spread of head and neck adenoid cystic carcinoma. Clin Radiol. 70(6):644-53, 2015
- Paes FM et al: Perineural spread in head and neck malignancies: clinical significance and evaluation with 18F-FDG PET/CT. Radiographics. 33(6):1717-36, 2013
- Lee TJ et al: Perineural spread of melanoma demonstrated by F-18 FDG PET with MRI and pathologic correlation. Clin Nucl Med. 33(2):106-8, 2008
- DeMonte F et al: Transmaxillary exploration of the intracranial portion of the maxillary nerve in malignant perineural disease. Technical note. J Neurosurg. 107(3):672-7, 2007
- Hanna E et al: The sensitivity and specificity of high-resolution imaging in evaluating perineural spread of adenoid cystic carcinoma to the skull base. Arch Otolaryngol Head Neck Surg. 133(6):541-5, 2007
- Nemec SF et al: Perineural tumor spread in malignant head and neck tumors. Top Magn Reson Imaging. 18(6):467-71, 2007
- Padhya TA et al: Perineural extension to the skull base from early cutaneous malignancies of the midface. Otolaryngol Head Neck Surg. 137(5):742-6, 2007
- Ojiri H: Perineural spread in head and neck malignancies. Radiat Med. 24(1):1-8, 2006
- Rumboldt Z et al: Imaging in head and neck cancer. Curr Treat Options Oncol. 7(1):23-34, 2006
- Kalina P et al: Perineural extension of facial melanoma. Neuroradiology. 47(5):372-4, 2005
- Chang PC et al: Perineural spread of malignant melanoma of the head and neck: clinical and imaging features. AJNR Am J Neuroradiol. 25(1):5-11, 2004
- Curtin HD: Detection of perineural spread: fat suppression versus no fat suppression. AJNR Am J Neuroradiol. 25(1):1-3, 2004
- Chong V: The skull base in oncologic imaging. Cancer Imaging. 4(1):5-6, 2003
- Williams LS et al: MR imaging of the trigeminal ganglion, nerve, and the perineural vascular plexus: normal appearance and variants with correlation to cadaver specimens. AJNR Am J Neuroradiol. 24(7):1317-23, 2003
- Ginsberg LE: MR imaging of perineural tumor spread. Magn Reson Imaging Clin N Am. 10(3):511-25, vi, 2002
- Schmalfuss IM et al: Perineural tumor spread along the auriculotemporal nerve. AJNR Am J Neuroradiol. 23(2):303-11, 2002
- Boerman RH et al: Trigeminal neuropathy secondary to perineural invasion of head and neck carcinomas. Neurology. 53(1):213-6, 1999
- Curtin HD: Detection of perineural spread: fat is a friend. AJNR Am J Neuroradiol. 19(8):1385-6, 1998
- Majoie CB et al: Perineural tumor extension along the trigeminal nerve: magnetic resonance imaging findings. Eur J Radiol. 24(3):191-205, 1997
- Eisen MD et al: Use of preoperative MR to predict dural, perineural, and venous sinus invasion of skull base tumors. AJNR Am J Neuroradiol. 17(10):1937-45, 1996
- Su CY et al: Perineural invasion of the trigeminal nerve in patients with nasopharyngeal carcinoma. Imaging and clinical correlations. Cancer. 78(10):2063-9, 1996
- Schifter M et al: Perineural spread of squamous cell carcinoma involving trigeminal and facial nerves. Oral Surg Oral Med Oral Pathol. 75(5):587-90, 1993
- Parker GD et al: Clinical-radiologic issues in perineural tumor spread of malignant diseases of the extracranial head and neck. Radiographics. 11(3):383-99, 1991
- Laine FJ et al: Perineural tumor extension through the foramen ovale: evaluation with MR imaging. Radiology. 174(1):65-71, 1990
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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Perineural tumor (PNT) of masticator space (MS) is malignant spread along CNV3 (mandibular branch of trigeminal nerve)
Synonyms
- PNT spread, PNT invasion
- Trigeminal ganglion = gasserian ganglion, semilunar ganglion
Definitions
- CNV3: 3rd division of trigeminal nerve (CNV)
- CNV3 PNT: Extension of malignancy along CNV3 allowing spread from MS though foramen ovale into Meckel cave (MC)
- MC: Small cistern for CNV
- Contains trigeminal ganglion in anterior aspect of MC
IMAGING
General Features
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Tsutsumi S et al: The emissary veins of the foramen ovale: an anatomical study using magnetic resonance imaging. Surg Radiol Anat. 42(7):771-7, 2020
- Agarwal M et al: Perineural tumor spread in head and neck malignancies. Semin Roentgenol. 54(3):258-75, 2019
- Bakst RL et al: Perineural invasion and perineural tumor spread in head and neck cancer. Int J Radiat Oncol Biol Phys. 103(5):1109-24, 2019
- Sipprell WH 3rd et al: Cranial neuropathies as the presenting symptom of cutaneous squamous cell carcinoma. JAAD Case Rep. 5(12):1037-40, 2019
- Dankbaar JW et al: Easily detected signs of perineural tumour spread in head and neck cancer. Insights Imaging. 9(6):1089-95, 2018
- Kirsch CFE et al: Practical tips for MR imaging of perineural tumor spread. Magn Reson Imaging Clin N Am. 26(1):85-100, 2018
- Malhotra A et al: Neuroimaging of Meckel's cave in normal and disease conditions. Insights Imaging. 9(4):499-510, 2018
- Badger D et al: Imaging of perineural spread in head and neck cancer. Radiol Clin North Am. 55(1):139-49, 2017
- Warren TA et al: The natural history and treatment outcomes of perineural spread of malignancy within the head and neck. J Neurol Surg B Skull Base. 77(2):107-12, 2016
- Singh FM et al: Patterns of spread of head and neck adenoid cystic carcinoma. Clin Radiol. 70(6):644-53, 2015
- Paes FM et al: Perineural spread in head and neck malignancies: clinical significance and evaluation with 18F-FDG PET/CT. Radiographics. 33(6):1717-36, 2013
- Lee TJ et al: Perineural spread of melanoma demonstrated by F-18 FDG PET with MRI and pathologic correlation. Clin Nucl Med. 33(2):106-8, 2008
- DeMonte F et al: Transmaxillary exploration of the intracranial portion of the maxillary nerve in malignant perineural disease. Technical note. J Neurosurg. 107(3):672-7, 2007
- Hanna E et al: The sensitivity and specificity of high-resolution imaging in evaluating perineural spread of adenoid cystic carcinoma to the skull base. Arch Otolaryngol Head Neck Surg. 133(6):541-5, 2007
- Nemec SF et al: Perineural tumor spread in malignant head and neck tumors. Top Magn Reson Imaging. 18(6):467-71, 2007
- Padhya TA et al: Perineural extension to the skull base from early cutaneous malignancies of the midface. Otolaryngol Head Neck Surg. 137(5):742-6, 2007
- Ojiri H: Perineural spread in head and neck malignancies. Radiat Med. 24(1):1-8, 2006
- Rumboldt Z et al: Imaging in head and neck cancer. Curr Treat Options Oncol. 7(1):23-34, 2006
- Kalina P et al: Perineural extension of facial melanoma. Neuroradiology. 47(5):372-4, 2005
- Chang PC et al: Perineural spread of malignant melanoma of the head and neck: clinical and imaging features. AJNR Am J Neuroradiol. 25(1):5-11, 2004
- Curtin HD: Detection of perineural spread: fat suppression versus no fat suppression. AJNR Am J Neuroradiol. 25(1):1-3, 2004
- Chong V: The skull base in oncologic imaging. Cancer Imaging. 4(1):5-6, 2003
- Williams LS et al: MR imaging of the trigeminal ganglion, nerve, and the perineural vascular plexus: normal appearance and variants with correlation to cadaver specimens. AJNR Am J Neuroradiol. 24(7):1317-23, 2003
- Ginsberg LE: MR imaging of perineural tumor spread. Magn Reson Imaging Clin N Am. 10(3):511-25, vi, 2002
- Schmalfuss IM et al: Perineural tumor spread along the auriculotemporal nerve. AJNR Am J Neuroradiol. 23(2):303-11, 2002
- Boerman RH et al: Trigeminal neuropathy secondary to perineural invasion of head and neck carcinomas. Neurology. 53(1):213-6, 1999
- Curtin HD: Detection of perineural spread: fat is a friend. AJNR Am J Neuroradiol. 19(8):1385-6, 1998
- Majoie CB et al: Perineural tumor extension along the trigeminal nerve: magnetic resonance imaging findings. Eur J Radiol. 24(3):191-205, 1997
- Eisen MD et al: Use of preoperative MR to predict dural, perineural, and venous sinus invasion of skull base tumors. AJNR Am J Neuroradiol. 17(10):1937-45, 1996
- Su CY et al: Perineural invasion of the trigeminal nerve in patients with nasopharyngeal carcinoma. Imaging and clinical correlations. Cancer. 78(10):2063-9, 1996
- Schifter M et al: Perineural spread of squamous cell carcinoma involving trigeminal and facial nerves. Oral Surg Oral Med Oral Pathol. 75(5):587-90, 1993
- Parker GD et al: Clinical-radiologic issues in perineural tumor spread of malignant diseases of the extracranial head and neck. Radiographics. 11(3):383-99, 1991
- Laine FJ et al: Perineural tumor extension through the foramen ovale: evaluation with MR imaging. Radiology. 174(1):65-71, 1990
