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DISTANT METASTASIS - The Trigeminal Nerve

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Case 1 - Recurrent basal cell carcinoma of right cheek with metastasis to right infraorbital nerve
This 64-year-old female had recurrent basal cell carcinoma in the right cheek following radiotherapy. Admission CT scan of the head and neck revealed soft tissue tumor mass in the region of the right nasolabial fold with perineural metastasis to the right infraorbital nerve. Patient underwent excision of the right side of the nose, partial maxillectomy and exploration of the right infraorbital nerve. Histopathology revealed poorly differentiated basal cell carcinoma in the connective tissue in the infraorbital region and in the perineural space of the infraorbital nerve. The tumor mass involved the infraorbital nerve.
Axial CT scan with IV contrast at the level of maxillary sinus and mid nasal cavity: a soft tissue mass in the right nasolabial region (1) with an extension to the right infraorbital nerve and enlargement of infraorbital foramen and canal (2).

 

 Axial CT scan with IV contrast at the level of the maxillary and sphenoid sinuses: there is a normal appearing pterygopalatine fossa on each side (arrows).

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