[Perineural spread in cancer].

This review highlights perineural spread, an important yet diagnostically challenging route of metastatic dissemination that significantly affects prognosis and often remains underrecognized. We discuss common clinical signs and symptoms, key imaging features, and the diagnostic approach, emphasising the diagnostic challenges and the critical roles of MRI and ¹⁸F-FDG PET/CT in PNS. Greater awareness of these diagnostic challenges is essential to improve accuracy and ultimately patient outcomes.