Home | About us | Editorial board | Ahead of print | Current issue | Archives | Search | Submit article | Instructions | Subscribe | Advertise | Contact us |  Login 
National Journal of Maxillofacial Surgery
Print this page Email this page Small font sizeDefault font sizeIncrease font size
Users Online: 3488
Year : 2022  |  Volume : 13  |  Issue : 3  |  Page : 488-490

Frozen section detected perineural spread in a grossly normal nerve away from tumor changes the surgical plan in parotid cancer

1 Department of Surgical Oncology, Government Medical College, Kottayam, Kerala, India
2 Department of Pathology, Government Medical College, Kottayam, Kerala, India
3 Department of General Surgery, Government Medical College, Kottayam, Kerala, India

Correspondence Address:
Dr. S Deepa
Department of Pathology, Government Medical College, Kottayam, Kerala
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/njms.njms_303_21

Rights and Permissions

Perineural spread (PNS) through the facial nerve is a well-recognized pathway of spread in parotid cancers. Negative margins in the facial nerve are important in the total extirpation of cancer. We report a case of mucoepidermoid carcinoma of the parotid which was involving only the upper temporofacial division of the facial nerve at the periphery clinically and per-operatively. The upper trunk was divided at about 3cm away from the tumor at its junction with the lower trunk and the nerve was grossly normal. To our surprise disease was extending at this distance as a PNS in the frozen section analysis. This unexpected finding made the resection margin positive and we had to sacrifice the main trunk of the facial nerve as back as possible in the parotidectomy field for a negative margin in the nerve which was confirmed with frozen section again. The case emphasizes the importance of microscopic margin assessment of facial nerve in parotid cancers with the involvement of nerve at branches, even if imaging is negative or gross disease is not seen at the cut end or distant from the tumor-involved area.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded24    
    Comments [Add]    

Recommend this journal