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
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
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)
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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