Head and neck tumors may invade perineural space, especially the maxillary division of the trigeminal nerve and the pterygopalatine fossa (PPF). Computed tomography (CT) and magnetic resonance imaging (MRI) signs of perineural extension include essentially the obliteration of the PPF fatty content and the enlargement and erosion of neural foramina. We report a case of perividian metastasis studied with CT and MRI.

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The aims of this article are to describe the findings of perividian tumor spread and to compare the accuracy of MRI and CT in diagnosing perineural metastasis along the vidian nerve. Moreover, the frequency of perividian metastasis in patients with head and neck cancer was evaluated. The CT and MR examinations of 98 consecutive untreated patients with histologically proven head and neck cancer were retrospectively reviewed.

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Intracranial metastasis from carcinoma of the paranasal sinus.

Neurosurgery

June 1991

Department of Neurosurgery, Royal Melbourne Hospital, Victoria, Australia.

Carcinomas of the paranasal sinuses are locally invasive tumors that only occasionally metastasize. The tumor may spread intracranially by local invasion through the dura into the frontal lobes and extension along the vidian nerve. We describe two cases of cerebellar metastasis in patients with local recurrence and discuss the mechanism of spreading.

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Head and neck tumors may invade perineural space, especially the maxillary division of the trigeminal nerve and the pterygopalatine fossa (PPF). Computed tomography (CT) and magnetic resonance imaging (MRI) signs of perineural extension include essentially the obliteration of the PPF fatty content and the enlargement and erosion of neural foramina. We report a case of perividian metastasis studied with CT and MRI.

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The perineural space is a well recognized pathway of tumor spread of head and neck cancer. We report a case of perividian metastasis studied with magnetic resonance imaging.

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Perineural spread is well known to be the most insidious form of tumour spread of a number of head and neck malignancies. However, perineural extension of nasopharyngeal carcinoma (NC) is a poorly recognized event. Four cases of perineural metastases from NC have been detected with pluridirectional tomography and CT.

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