Do you obtain MRI for cutaneous SCC with microscopic PNI to assess for gross perineural tumor spread?  

I would recommend both an MRI as well as consulting the pathologist regarding the exact nature of the PNI. We had an experience with more than 100 patients (Sapir et al., PMID 27475277). Those with gross PNI (evidenced by MRI, with or without cranial nerve deficit) and microscopic extensive PNI (>...

I consider MRI with contrast to assess for perineural spread when patients report neurologic symptoms or have neurologic signs in the dermatome or myotome of the cutaneous squamous cell carcinoma. I also consider MRI in the absence of symptoms if the caliber of the nerve involved in histopathologic ...

Great question. I typically do get an MRI skull base w/wo contrast for two reasons. Occasionally, you can see gross nerve involvement which will clearly change your treatment plan. Secondly, even if it is negative, cranial nerves frequently enhance after radiation. Having a baseline that showed no i...

I do. That said, it’s low yield in an asymptomatic patient. Get a CT to evaluate nodes

I get an MRI for all PNI cases - It's a face/neck cranial nerve protocol with fine 1 mm cuts and contrast - mainly look at the trigeminal nerve and facial nerve pathways and interconnections for skin cancers. Most importantly, let your neuro-radiologist clearly know that you are looking for PNTS (pe...