Management and prognostic factors of recurrent pleomorphic adenoma of the parotid gland: personal experience and review of the literature
Open Access
- 25 October 2007
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Archives of Oto-Rhino-Laryngology
- Vol. 265 (4), 447-452
- https://doi.org/10.1007/s00405-007-0502-y
Abstract
The aim of this study was to investigate the management and prognostic determinants of recurrent pleomorphic adenoma (RPA). A retrospective analysis was performed to examine the clinical features, the prevalence of surgical complications, and new recurrences of RPA. Tumor recurrence rate was estimated by the Kaplan–Meier method, and the prognostic value of some of the variables was tested by univariate analysis using the log rank test. The study focused on 33 patients, 18 female (54.5%) and 15 male (45.5%), aged 12–71 years (median 41). A total or extended total parotidectomy was performed in 16 cases (48.5%), a superficial parotidectomy in 10 cases (30.3%), and a local excision in 7 cases (21.2%). In ten patients (30.3%), a branch or the trunk of the facial nerve was deliberately sacrificed. Major complications included one unexpected definitive paralysis of the marginal mandibular branch of the facial nerve and 14 cases of Frey syndrome. Follow-up varied from 2 to 25 years (median 10.5 years), and there were 11 new recurrences (33.3%) within a period varying from 1 to 16 years (median 6 years). The estimated tumor recurrence rates were 14.1 ± 6.6% at 5 years, 31.4 ± 9.4% at 10 years, 43.0 ± 10.8% at 15 years, and 57.2 ± 14.8% at 20 years. Presence of a multinodular lesion and the type of intervention performed were significantly associated with a higher probability of recurrence. RPAs are prone to new recurrences, especially when multinodular and treated with a local excision. Surgical treatment should include facial nerve resection in selected cases. Follow-up for the patient’s lifetime is warranted.Keywords
This publication has 30 references indexed in Scilit:
- Recurrent pleomorphic adenoma of the parotid gland: Analysis of 108 consecutive patientsHead & Neck, 2007
- Recurrent Pleomorphic Adenoma of the Parotid GlandOtolaryngology -- Head and Neck Surgery, 2005
- Stereotactic Radiosurgery for Recurrent Pleomorphic Adenoma Invading the Skull Base-Case Report-Neurologia medico-chirurgica, 2005
- Mucin expression in pleomorphic adenoma of salivary gland: a potential role for MUC1 as a marker to predict recurrenceJournal of Clinical Pathology, 2004
- Neutron radiotherapy for recurrent pleomorphic adenomas of major salivary glandsHead & Neck, 2001
- Histopathology of Pleomorphic Adenoma in the Parotid Gland: A Prospective Unselected Series of 100 CasesThe Laryngoscope, 2001
- Recurrent salivary gland pleomorphic adenoma: etiology, management, and resultsCurrent Opinion in Otolaryngology & Head and Neck Surgery, 2001
- Preservation of the facial nerve in the management of recurrent pleomorphic adenomaThe Laryngoscope, 1991
- Recurrent pleomorphic adenomas of the parotid glandHead & Neck, 1990
- Capsular significance in parotid tumor surgery: Reality and myths of lateral lobectomyThe Laryngoscope, 1984