What is perineural invasion in skin cancer?

Posted on: May 8th, 2023 by Our Team

Perineural invasion, also known as neural invasion, is a term used to describe the spread of cancer cells along the nerves in the skin. It is a significant finding in the treatment of cutaneous squamous cell carcinoma, a type of skin cancer affecting the outermost skin layers.

Suppose you live in Scottsdale or Phoenix, Arizona, and have recently been diagnosed with cutaneous squamous cell carcinoma. In that case, you may consider Mohs micrographic surgery as a treatment option. This specialized type of surgery is used to remove skin cancer while minimizing the risk of scarring and preserving as much healthy tissue as possible.

During Mohs surgery, the surgeon removes thin layers of skin one at a time and examines them under a microscope to check for any remaining cancer cells. This process is repeated until all of the cancer cells have been removed.

One of the critical advantages of Mohs surgery is that it allows the surgeon to accurately stage cancer, including identifying the presence of perineural invasion. This is an essential factor to consider in treating cutaneous squamous cell carcinoma, as perineural invasion can affect the prognosis and the recommended course of treatment.

Perineural invasion occurs when cancer cells spread along the nerves in the skin. This can make cancer more difficult to treat and increase the recurrence risk. It is more common in certain types of skin cancer, such as squamous and basal cell carcinoma. It is more likely to occur in more significant or more aggressive cancers.

The presence of perineural invasion can also affect the pain associated with cancer. Cancer cells invade the nerves and cause pain or numbness in the affected area. This can be a significant concern for patients, as uncontrolled pain can significantly impact their quality of life.

Your surgeon will discuss your treatment options if the perineural invasion is detected during Mohs surgery. Depending on the extent of the perineural invasion and the location of cancer, your surgeon may recommend additional surgery to remove the affected nerves or referral to a specialist for further evaluation and treatment.

In some cases, the perineural invasion may be treated with radiation therapy or chemotherapy. Depending on the case’s specifics, these treatments can be used alone or in combination with surgery.

It is important to note that perineural invasion does not necessarily mean cancer cannot be cured. On the contrary, many patients can achieve a good outcome with proper treatment and follow-up care.

Suppose you have been diagnosed with cutaneous squamous cell carcinoma and are considering Mohs surgery. In that case, it is essential to discuss all of your treatment options with your surgeon. Your surgeon can provide more information about the perineural invasion and how it may affect your treatment plan.

In conclusion, perineural invasion is a significant finding in the treatment of cutaneous squamous cell carcinoma and can affect the prognosis and recommended course of treatment. If you live in Scottsdale or Phoenix, Arizona, and have been diagnosed with this type of skin cancer, consider discussing Mohs micrographic surgery with our renowned Mohs surgeon at Phoenix Surgical Dermatology Group, Dr. Ramin Fathi, who has extensive experience with high-risk skin cancers.