Perineural metastasis may occur from any head and neck malignancy, especially adenoid
cystic carcinoma, squamous cell carcinoma and lymphomas. Perineural metastasis is an
important but often neglected route of spread of the tumor of the head and neck.
Recognition of this form of metastatic spreading of the tumor is essential for adequate
Certain cranial nerves, both centrally and peripherally, are confined in the bony
foramina and canals. Enlargement of the nerves by malignant permeation of the perineural
spaces may be reflected by the expansion and erosion of the surrounding bony envelope. The
cranial nerves most amenable to the demonstration of the malignant permeation are the
trigeminal, facial, and hypoglossal
cranial nerves. Although the other nine cranial nerves can be involved, they traverse
relatively large foramina and fissures which are not affected by the enlargement of the
involved nervous trunks.
This computerized exhibit demonstrates manifestations of the perineural metastasis to
the trigeminal, facial, and hypoglossal cranial nerves in head and neck malignancies.