A 42-year-old man with facial nerve weakness and multiple recurrent pleomorphic adenoma

Objective: To describe a case and discuss the differential diagnosis of facial nerve paresis presenting years after resection of multiple recurrent parotid pleomorphic adenoma. Patients: Case report of a patient on immunosuppressive therapy with facial nerve weakness 3 years after last resection for multiple recurrent pleomorphic adenoma. Interventions: Computed tomography and magnetic resonance imaging followed by surgical exploration, resection, and reconstruction. Main Outcome Measures: Histopathologic diagnosis and treatment outcome. Results: Final diagnosis of recurrent pleomorphic adenoma causing compression of the facial nerve at the stylomastoid foramen. Conclusion: Facial nerve weakness caused by a benign salivary gland tumor is rare. Although alternate diagnoses must be considered, recurrent pleomorphic adenoma alone may impair facial function by impinging on the nerve in the stylomastoid foramen.