Posts Tagged ‘Perineural Invasion’
Sensory Symptoms with Skin Cancers
HISTORY A 68-year-old woman presented with left cheek radiating, shooting pains in the area of biopsy proven basal cell carcinoma. The neuralgia symptoms radiated to the nose, eye, and temple. MRI of the face was non-contributory. Mohs excision was performed by the dermatologist. Additional margin wide local excision was performed at the reconstructive procedure. Patient…
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Upper Chest BCC PNI
HISTORY 53-year-old man presents with a 4-year-history of BCC of upper chest. The tumor measured 12 cm x 6 cm. Wide local excision with 1 cm margins on 11/10/2017 found clear margins and perineural invasion. The nerves up to 0.23 mm were involved by tumor. The final defect was 13.5 cm x 8.3 cm. …
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SCC of Scalp
HISTORY 86-year-old man presents with 3-month history of a mass in the left occipital scalp. 1 year prior, the patient underwent Mohs excision of a large scalp SCC. FNA biopsy on 1-22-18 found atypical squamous cells. CT PET scan showed cancer limited to the mass itself with no lymph node enhancement. Patient experienced progressively increasing…
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BCC Left Upper Lip
HISTORY 87-year-old man presents with 1 year history of lesion on left upper lip. Biopsy taken 11-16-2017 and pathology showed basal cell carcinoma. Mohs excision and reconstruction were performed on 1-19-18. Mohs slide histology was presented for review. A question of appearance of perineural invasion was discussed. DISCUSSION The Mohs slides…
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Forehead SCC with Perineural Invasion
HISTORY 83-year-old man presented in 02/2017 with a 3-year history of a forehead and temple SCC. The cancer was initially treated with cryoablation and 5-FU. Excision on 9/2/16 was performed with residual circumferential margins. Histology found poorly differentiated sclerosing squamous cell carcinoma, with perineural invasion of 0.1 mm nerves. Wide local resection with radial…
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Deeply Invasive Squamous Cell Carcinoma of Cheek
HISTORY: 82-year-old man with a 1 year history of squamous cell carcinoma on the right lower cheek biopsied on 4/28/2017. Radical resection of the right cheek carcinoma and deep facial lymph node biopsy was performed. Intraoperative Mohs margin evaluation confirmed clear margins. Final permanent histology margins were close but clear. Evidence of perineural invasion…
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Aggressive Forehead SCC
History 78-year-old man with a recurrence of squamous cell carcinoma of forehead following surgery and radiation. Resection was performed in 4/2016 and radiation followed. Lesion recurred within 1 week of completion of radiation within radiation field. Originally presented with squamous cell carcinoma with perineural invasion and 4.5mm depth of invasion, arising from squamous cell carcinoma…
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MEDIAL CANTHUS BASAL CELL CARCINOMA FOLLOW UP
HISTORY 91 year old man presented with a recurrent right medial canthus BCC that was previously treated with 45 days of radiation (SRT at Hoag Hospital). Biopsy showed infiltrative sclerosing basal cell carcinoma with focal perineural invasion. MRI in December of 2016 showed the mass was fixed on the lamina papyracea adjacent to the medial…
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EYEBROW AND FOREHEAD SQUAMOUS CELL CARCINOMA
HISTORY 104 year old man presented in 2/2017 with basal cell carcinoma of the left frontal scalp and basosquamous carcinoma of the left eyebrow. On 3/21/2017 the patient underwent a wide local excision and Mohs margin excision of orbit and forehead. At the time he also had Mohs excision of the scalp forehead basal cell…
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Squamous Cell Carcinoma Lower Lip
A man in his thirties with lifelong h/o severe actinic cheilitis of left lower lip. Recurrent flare-ups of cheilitis have been treated as recurrent herpetic infection. Recently he has experienced worsening of cheilitis and appearance of the lesion. Biopsy found squamous cell carcinoma with perineural invasion. Lip invasion was histologically measured to be > 2mm…
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