Recurrent pleomorphic adenoma: uninodular versus multinodular disease.
BACKGROUND
While treatment of previously untreated pleomorphic adenoma is relatively straightforward, recurrent pleomorphic adenoma presents a management problem with increased risk of injury to the facial nerve and an increased risk of malignant transformation in recurrent disease.


OBJECTIVE
The objectives of this study were to review the management of recurrent pleomorphic adenoma in our unit to identify factors that might help treatment of future cases.


METHODS
We reviewed the management of pleomorphic adenoma at our department over an eight-year period from 1990-1998 and present our experience of recurrent pleomorphic adenoma of the parotid gland and parapharyngeal space.


RESULTS
Twelve patients were treated with recurrent pleomorphic adenoma. In 10 of these, the site of recurrence was in the parotid gland with the remainder occurring in the parapharyngeal space. Type of recurrence was uninodular or multinodular, the former being easier to treat. Three patients required adjuvant radiotherapy. None of our patients had permanent facial nerve damage.


CONCLUSIONS
In order to prevent recurrence of pleomorphic adenoma of the parotid gland, we recommend formal superficial parotidectomy for first time surgery.
Department of Otolaryngology, Mater Misericordiae Hospital, Dublin.
H
H
Rowley
M
M
Murphy
D
D
Smyth
T P
TP
O'Dwyer
D008949:Adenoma, Pleomorphic / Q000473:pathology / Q000601:surgery*; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010306:Parotid Gland / Q000601:surgery*; D010307:Parotid Neoplasms / Q000473:pathology / Q000601:surgery*