CT and MRI features of perineural tumor spreading along the trigeminal nerve in malignant head and neck tumors / 中华放射学杂志

ABSTRACT

Objective To study the imaging features regarding perineural spread of tumor along the trigeminal nerve in malignant head and neck tumors, investigate its usefulness in improving diagnostic accuracy and palnning for clinical treatment. Methods Images in 9 patients with clinical or radiological findings suggestive of perineural spread along trigeminal nerve were retrospectively studied. Results Among the 9 patients, 6 were adenoid cystic carcinoma of the hard palate (n=3), maxillary sinus (n=1), parotid gland (n=1) and buccal space (n=1), respectively. Two were nasopharyngeal carcinoma and 1 was squamous carcinoma of the maxillary sinus. Enlargement and fat effacement of greater palatine foramen and pterygopalatine fossa distant from primary diseases were seen in all the 3 patients with adenoid cystic carcinoma of the hard palate and 1 with squamous carcinoma of maxillary sinus, furthermore, enlargement of foramen ovale and invasion of meckal cave was seen in 1 case. Erosion of infraorbital foramen and enlargement of the pterygopalatine fossa was seen in 1 patient with adenoid cystic carcinoma of maxillary sinus. Enlargement of pterygopalsatine fossa and foramen rotundum and invasion of the Meckal cave were seen in 1 patient with adenoid cystic carcinoma of buccal space. Perineural spread along auriculotemporal nerve and intracranial invasion through foramen ovale were seen in 1 patient with adenoid cystic carcinoma of parotid gland. Enhancement of mandibular nerve was seen in 2 patients with nasopharyngeal carcinoma. Conclusion Perineural tumor spread along trigeminal nerve can be seen in malignant head and neck tumors, and knowledge of the anatomy of trigeminal nerve and its surrounding structures is important for correct diagnosis.