Perineural spread of tumour

Perineural spread of tumour is a form of local invasion in which primary tumours cells spread along the tissues of the nerve sheath.  It is a well-recognised phenomenon in head and neck cancers.

An important distinction has to be made between perineural invasion (PNI) and Perineural spread (PNS). The former is a histological finding of tumour cell infiltration or associated with small nerves that cannot be radiologically imaged, while the latter is macroscopic tumour involvement along a nerve extending away from the primary tumour; this can be radiologically apparent.  A third term, neurotropism, simply means that a tumour has an affinity for growth along nerves.


Perineural tumour spread is more frequently associated with 1,2,5:

Radiographic features


Perineural tumour spread could be characterised as nerve thickening, widening of the neural foramen, loss of the fat surrounding the nerve and enhancement of the nerve following contrast administration. 

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Article information

rID: 33252
Section: Pathology
Tag: cases
Synonyms or Alternate Spellings:
  • Perineural spread
  • Perineural tumor spread
  • Perineural tumour spread

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Cases and figures

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    Case 1: cutaneous SCC and infraorbital nerve
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    Case 2: SCC along branches of trigeminal and facial nerve
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