Pathologic Staging Categories for Head and Neck Mucosal Melanoma (a,b) pT Primary Tumor pTx Primary tumor cannot be assessed T3 Tumors limited to the epithelium and/or submucosa (mucosal disease) [regardless of thickness or greatest dimension] (c) T4a Moderately advanced disease Tumor invades deep soft tissue, cartilage, bone, or overlying skin T4b Very advanced disease Tumor invades any of the following: brain, dura, skull base, lower cranial nerves (IX, X, XI, XII), masticator space, carotid artery,
prevertebral space, or mediastinal structures (a) Reproduced with permission from Union for International Cancer Control (UICC) in Brierley et al (3): Brierley JD, Gospodarowicz MK, Wittekind C, eds.
Plain radiograph of the neck in lateral view revealed
prevertebral soft tissue enlargement (Figure 1) with no calcification or air.
The needle tip was placed subfascially between the longismus colli and
prevertebral fascia (Figure 2).
Fibrosing mediastinitis manifesting as thoracic
prevertebral thin band-like mass on MRI and PET-CT.
Extraneural findings were disc herniation, ligamentum flavum bulging,
prevertebral soft tissue swelling, or ligamentous abnormalities [33].
The cervical plexus block was performed as a plane block in the
prevertebral fascia posterior to the SCM muscle.
Caption: Figure 2: Axial MRI slice five days after incision and drainage of the
prevertebral abscess: contrast-enhanced T1-weighted axial MRI scan shows the incised abscess cavity (white asterisk) which is connected to a progressive fluid retention especially in the area between the dorsal ligament and the ventral dura with a slight compression of the myelon (white arrow).
Prevertebral abscess is one of the uncommon deep neck space infection, occupies the
prevertebral space between the vertebrae bodies and
prevertebral fascia, and extends from the base of the skull to the coccyx.
Edema was also noted in the
prevertebral and interspinous ligaments spanning C1-C2 and C2-C3.
Finally, it transverses the posterior triangle of the neck, superficial to the
prevertebral fascia, and terminates with its branches in the deep surface of the trapezius muscle.
Moreover, the landmarks in zone 3 start from the angle of the mandible to base of skull and also house eminent structures like the internal carotid artery, vertebral artery, external carotid artery, jugular veins,
prevertebral venous plexus, and facial nerve trunk [3, 8, 9, 14, 25, 27, 28].
The phrenic nerve (C3-C5) and brachial plexus lie deep to the
prevertebral fascia, thus local anesthetic administration after a brachial plexus block can result in medication "spilling" over onto the phrenic nerve.
