The Ten Cases of Recurrent Pleomorphic Adenoma of Parotid Gland

Choi, Jong Ouck; Kim, Woong Sik; Park, Ji Hoon; Yang, Si Chang; Sung, Tae Hyun; Ko, Tae Ok

Abstract

BACKGROUND: The main cause of recurrent pleomorphic adenoma of the parotid gland is known to be incomplete surgical excision or accidental rupture of tumor pseudocapsule during surgery, which results in spillage of tumor cells into the wound. Recurrent pleomorphic adenoma of the parotid gland warrants consideration since there is a potential for the risk of malignant conversion. OBJECTIVES: We investigated clinical characteristics of recurrent pleomorphic adenoma of the parotid gland and analyzed the results of the treatment to establish surgical management modalities.
MATERIALS AND METHODS
We examined retrospectively 10 cases of recurrent pleomorphic adenoma of the parotid gland and reviewed their clinical features, histopathologic findings, operative findings and postoperative outcomes. Six cases were female and four were male with the mean age of 45.8 years at the time of treatment. The average follow up period was six years and three months.
RESULTS
Primary treatments included mass enucleation in seven cases and superficial parotidectomy in three cases. We performed total parotidectomy via anterior approach for all cases and limited neck dissection on level II was performed for six cases in whom the tumor spread was suspected. No patient experienced permanent facial nerve paralysis and tumor recurrence postoperatively except for two patients who died of lung metastasis despite radical tumor extiration and radiotherapy.
CONCLUSION
Recurrent pleomorphic adenoma of the parotid gland is largely dependent on primary treatment. Recurrent tumors usually have multiple lesions, therefore total parotidectomy with limited neck dissection should be combined as a treatment modality and always been in mind the possibility of malignant conversion.