Treatment of perineural metastasis from squamous carcinoma of the skin with aggressive combination chemotherapy and irradiation

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Abstract
Perineural metastasis from squamous cell carcinoma is quite rare. The treatment of such metastasis in the head and neck region is difficult due to base of skull or intracranial involvement by tumor. Surgery and radiotherapy may provide local control, but patients often fail distantly. We present a patient with squamous cell carcinoma presenting with perineural metastasis who was successfully treated with combination chemotherapy and definitive radiation therapy. Suggestions of therapeutic management are made of this uncommon clinical problem.