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Suggest treatment for adenocarcinomas spreading to perineural tissue

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Posted on Wed, 20 May 2015
Question: Hello, 7 months ago i was diagnosed with Polymorphous low-grade adenocarcinoma i had a tumor in my mouth upper right cheek, I had surgery to remove this, when the results came back they said they had found more which required further surgery,when i asked why this second bit hadn't shown on the scans they said it was not visible to the naked eye and was in the cells? on my doctors notes it said adenocarinoma NOS i has CT scans in oct 2014 and MRI scans which they said was all clear.
In March i had a pain in my neck and collar bone area, i was told this was due to my psoriatic arthritis the pain moved into my back and down my right leg,my right eye lid has drooped my doctor has sent me for a brain scan waiting results, i have pins and needle sensation in my right hand and right foot, i also have icy cold hands and feet ? i am worried sick waiting for results is it possible for this type of cancer to have spread ?
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Answered by Dr. Sumit Bhatti (9 hours later)
Brief Answer:
Adenocarcinomas are known to spread via perineural invasion.

Detailed Answer:
Hi,

Thank you for your query.

1. Adenocarcinomas have a propensity to spread along perineural tissue. Recurrence and skip lesions are common.

2. Any microscopic tumor cells that had perineural invasion would show up after a few months or years as these are slow growing (low grade) tumors.

3. MRI with contrast will be be the best imaging, however it it time to consider a PET Scan before planning treatment. Upload the images.

4. A re[eat biopsy should be taken to confirm if this is the same tumor.

5. The facial nerve and orbit (occulomotor nerve) should be checked.

6. This time around, the surgery has to be more comprehensive, with post operative radiotherapy. Though these tumors are less sensitive to radiotherapy and chemotherapy, it does give good results in many patients.

7. You may follow up with these images and reports (biopsy) here or directly at bit.ly/Dr-Sumit-Bhatti

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2652 Questions

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Suggest treatment for adenocarcinomas spreading to perineural tissue

Brief Answer: Adenocarcinomas are known to spread via perineural invasion. Detailed Answer: Hi, Thank you for your query. 1. Adenocarcinomas have a propensity to spread along perineural tissue. Recurrence and skip lesions are common. 2. Any microscopic tumor cells that had perineural invasion would show up after a few months or years as these are slow growing (low grade) tumors. 3. MRI with contrast will be be the best imaging, however it it time to consider a PET Scan before planning treatment. Upload the images. 4. A re[eat biopsy should be taken to confirm if this is the same tumor. 5. The facial nerve and orbit (occulomotor nerve) should be checked. 6. This time around, the surgery has to be more comprehensive, with post operative radiotherapy. Though these tumors are less sensitive to radiotherapy and chemotherapy, it does give good results in many patients. 7. You may follow up with these images and reports (biopsy) here or directly at bit.ly/Dr-Sumit-Bhatti I hope that I have answered your query. If you have any more questions I will be available to answer them. Regards.