Perineural spread of non-melanoma skin cancer to the brachial plexus: identifying an anatomical pathway(s).

Perineural spread of non-melanoma skin cancer to the brachial plexus: identifying an anatomical pathway(s).

World Neurosurg. 2018 Mar 20;:

Authors: Marek T, Howe BM, Amrami KK, Spinner RJ

Abstract
BACKGROUND: Perineural spread leading to brachial plexopathy has recently been described in cases of melanoma. The occurrence and mechanism for non-melanoma skin cancer spread to the brachial plexus is poorly understood.
MATERIALS AND METHODS: A retrospective chart review of Mayo Clinic database was conducted to identify patients with non-melanoma skin cancer and brachial plexopathy between 2000 and 2017. Inclusion criteria were a history of non-melanoma skin cancer, a clinical diagnosis of brachial plexopathy, imaging features of perineural spread, and a positive biopsy showing tumor in a skin nerve.
RESULTS: Thirty-seven patients with a history of non-melanoma skin cancer and brachial plexopathy were identified. Inclusion criteria were fulfilled in 2 cases of cutaneous squamous cell carcinoma. One case of recurrent basal cell carcinoma with perineural spread confirmed in the brachial plexus by pathology was excluded because of confirmatory evidence of perineural spread from the skin to the brachial plexus was not available.
CONCLUSION: Perineural spread of non-melanoma skin cancer leading to brachial plexopathy is rare. Our 2 cases and the cases found in the literature demonstrate different entry points to the neural highway resulting in neurological deficits. The cervical plexus serves as a hub for further spread in certain cases of perineural spread of skin cancer.

PMID: 29572176 [PubMed - as supplied by publisher]

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