Perineural Spread of Cutaneous Basal and Squamous Cell Carcinomas

Five patients were studied in whom a trigeminal or facial neuropathy resulted from perineural spread of basal or squamous cell carcinomas arising in the skin of the face. The cause of the neuropathy was not immediately apparent because there was no evidence of local skin recurrence in any of the patients after the onset of their neurologic symptoms. Pain was a prominent feature in those patients with trigeminal involvement. Radiologic investigations were helpful in only one patient. The diagnosis should be suspected when symptoms and signs are confined initially to superficial branches of the trigeminal or facial nerves and later extend to more central branches in the order in which they arise. Confirmation can be made by microscopic examination of the nerves involved.