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Basal cell with perineural invasion.

Posts: 1
Joined: Oct 2016

45 year old male, healthy, no tobacco use ever, no drugs ever, and no alcohol ever...I work as a foreman on a concrete construction crew, so I am outdoors 8 to 10 hours a day.

Had a small sore appear on my forehead about 14 months ago. Very small, about 1/8 inch. It would scab over, scab would fall off, and repeat. Went to my family Dr. He said it was nothing. Attempted to freeze it off. Scabbed over, appeared to be healing, then the same thing.
 Went back a second time to my family Dr. Again tried to freeze it off. Still said it was nothing. Appeared to be healing, but the same thing again.

Went to a Dermatologist on my own. Removed the sore for a biopsy, came back Basal cell. Six weeks later went back to have it removed, he cut it out, sent off for testing/biopsy. One week after having it removed I went back to have the stitches out. He told me that all the margins were clear, so he was certain he fromved it all...BUT... He then proceeded to scared the crap out of me by telling me it came back as an aggressive type of basal cell with perineural invasion.

He recomended I see an Oncologist for radiation therapy. I have an appointment in one week for that. I have done some research on-line. I understand that perineural invasion means that the sheath covering a nerve or nerves showed evidence that the tumor or cancerous cells had attached to it and could possible spread locally or to a site farther away.

Has anyone else here had any experience with this?

How worried should I be? Dermatologist told me I shouldnt lose any sleep over it, that the radiation was just a follow up to make certain all the cancerous cells were killed. But still...

He said the radiation would be localised to the spot on my forehead. What is it liike having this? Should I have this?

What about the prognosis for this? Life expectancy? Recurrence?

Please someone help...


Posts: 32
Joined: Jul 2015

It would appear that perineural invasion is pretty rare but I have it too although my history is different that yours.  I had symptoms for a year or so before I was diagnosed.  First my ear became quite numb.  Eventuallly the left side of my face became paralysed.  I was diagnosed with Bells Palsy so I waited for it to go away but it never did.  I must have spoken to  or visited a dozen Drs about it.  Finally I went to the University of Wisconsin hospital where the took a biopsy inside my cheek and told me it was cancer- squamous cell.  I was stunned.  I had gone to my ENT, my dentist and made four trips to two different neurologists and no one ever raised the possibility of cancer.

   I had radiation for 33 or so treatments and carboplatin chemotherapy.  My Dr told me before I started that I had "extensive spreading" in my facial and cranial nerves.  Now a year and three months later my lastest MRI shows recurrence by my ear but no spreading to other parts of my body.  It looks like I'll be entering a clinical trial as soon as a spot opens up and get two kinds of chemotherapy and a daily pill that is a PARP inhibitor.  I cant find much on the internet about perineural cancer or find people that have it but my Dr told me from the start that its was most likely that they wouldn't get it all because it doesn't show up on MRI untill theres a good deal of it.  About five years prior to all this I had a diagnosis of squamous cell skin cancer on my cheek - small and they took it out and told me I was good but now they think it got into my nerves and is the cause of my present troubles.  My Dr recently told me that if I had no treatment I would die in approximately one year.  So they think this is from sun exposure and even though its in my nerves there calling it skin cancer.  It sounds like yours is smaller area than mine.  I am 63 years old. 


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