Recurrent pleomorphic adenomas of the parotid gland - Treatment and outcome

Yaron Nazarian, Yoav P. Talmi, Michael Wolf, Zeev Horowitz, Lev Bedrin, Rephael Pfeffer, Jona Kronenberg

Research output: Contribution to journalArticlepeer-review

Abstract

Epithelial tumors of the parotid gland comprise 3% of head and neck tumors, and 70%-80% of those are benign. Pleomorphic adenoma is the most common tumor of the parotid gland. Recurrence rate of pleomorphic adenomas (RPAs) following superficial parotidectomy was reported to be as high as 4%, sometimes associated with inadequate surgical treatment of the primary tumor. These tumors have a very slow growth rate, and a ten-year follow-up period is mandatory. RPAs are usually located in the superficial lobe (75%) and are often multinodular. Treatment of RPAs is challenging due to a high risk of facial nerve paresis (7%-50%) and of re-recurrence. Occasionally, post-operative radiotherapy is indicated, but this treatment must be balanced with potential long term risks of secondary malignancy. Medical records of 16 patients with first recurrence and 4 patients with more than one recurrence who were treated in our institution during the past 5 years were reviewed. Five patients were treated by post-operative radiotherapy. Residual or recurrence rate following a second procedure was 15%. Two patients (10%) had permanent paresis of a single branch of the facial nerve. Seventeen out of 20 patients (85%) treated were disease-free after a follow-up period of 5 years. In conclusion, surgical treatment of RPAs is a complex procedure which should be managed by a trained surgical team and can be performed with success and minimal morbidity.

Original languageEnglish
Pages (from-to)82-84
Number of pages3
JournalHarefuah
Volume146
Issue number2
StatePublished - Feb 2007

Keywords

  • Facial nerve
  • Parotid
  • Pleomorphic adenoma
  • Radiation
  • Recurrence

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