The Spread of Squamous Carcinoma of the Skin Via the Cranial Nerves

Abstract

1 Squamous carcinoma of the skin may spread along cranial nerves and their branches for considerable distances in either direction, and may even reach the brain. There is good evidence that perineural lymphatics do not exist. 2 A knowledge of the anatomy of the cranial nerves and cranial foramina is important. 3 The diagnostic radiologist has the potential to help his clinical colleagues with special views of the foramina, tomography and the CT scan. 4 When a patient with a skin cancer, or a past history of a skin cancer, develops symptoms indicating an abnormality in one or more cranial nerves or their branches, then the clinician must be aware of the possibility of this diagnosis. Recurrence of squamous carcinoma or the finding of a subcutaneous plaque of squamous carcinoma may be associated with perineural spread. 5 Treatment is difficult and the results of treatment are poor. Best results are likely to be achieved before the condition is advanced. 6 Surgeon and radiotherapist should realise the need both for close cooperation and the radical use of each treatment modality. Post operative radiotherapy is mandatory before recurrence occurs.