Hide‐and‐seek: Neurotropic squamous cell carcinoma of the periorbital region – a series of five cases and review of the literature

• Published in: Journal der Deutschen Dermatologischen Gesellschaft Vol. 19; no. 11; pp. 1571 - 1580
• Main Authors: Morandi, Evi M., Rauchenwald, Tina, Puelzl, Petra, Zelger, Bernhard W., Zelger, Bettina G., Henninger, Benjamin, Pierer, Gerhard, Wolfram, Dolores
• Format: Journal Article
• Language: English
• Published: Germany Wiley Subscription Services, Inc 01.11.2021; John Wiley and Sons Inc
• Subjects: Basal cell carcinoma; Cancer; Carcinoma, Basal Cell; Carcinoma, Squamous Cell - diagnosis; Central nervous system; Cranial nerves; Face; Humans; Invasiveness; Literature reviews; Malignancy; Neoplasm Invasiveness; Review; Risk factors; Skin Neoplasms - diagnosis; Squamous cell carcinoma
• ISSN: 1610-0379; 1610-0387
• DOI: 10.1111/ddg.14582

Summary Squamous cell carcinoma is the second most common malignancy of the skin after basal cell carcinoma and mainly found in sun‐exposed areas such as the face. This mostly locally destructive malignancy may show invasive growth and insidious mechanisms of dissemination such as perineural invasion. Periorbital squamous cell carcinoma is associated with perineural invasion in up to 14 % of cases. Specifically in this region, the proximity to cranial nerves and therefore the associated risk of progression to the central nervous system are associated with poor prognosis. The clinically concealed character of this entity often leads to a delay in diagnosis and consequently makes complete resection and reconstruction demanding. Careful clinical evaluation often hints at perineural invasion before obtaining histology. Aside from presenting five challenging cases, this work analyzes risk factors, clinical as well as histological features, and treatment options for periorbital squamous cell carcinoma with perineural invasion.