PERINEURAL AND NEURAL INVOLVEMENT IN SKIN CANCERS

BACKGROUND. Malignant skin tumors rarely spread along nerves. Complete resection of involved nerves is often unsuccessful. OBJECTIVE. In the treatment of tumors with perineural invasion, surgeons should accurat ely estimate the extent of distant spread. METHODS. We report six case s of skin cancers, including two basal cell carcinomas, two squamous c ell carcinomas, and two neurotropic malignant melanomas, that invaded nerve or perineural spaces. RESULTS. In three of the cases, the tumors developed on the face and involved the infraorbital nerves or its bra nches. Two patients suffered from tumors on old burn scars of lower le gs. Branches of posttibal nerves were involved in both cases. In the l ast case, tumor invasion of a branch of the greater occipital nerve wa s detected. CONCLUSION. The extent of surgical excision should include the area of skin supplied by the affected nerve, which must be resect ed in continuity. (C) 1997 by the American Society for Dermatologic Su rgery, Inc.