title: Recurrent pleomorphic adenoma of the parotid gland in pediatric and adult patients: value of multiple lesions as a diagnostic indicator.
abstract: OBJECTIVE
  Recurrent pleomorphic adenoma of the parotid gland is a significant problem. Rates have been as high as 40% in some series of patients who have undergone surgery for the primary lesion. In the imaging literature, anecdotal case reports show multiple lesions in recurrent pleomorphic adenoma. Our aim was to analyze the imaging of a series of patients to determine the reliability of multiple lesions as a tool in diagnosing recurrent disease.
  
  
  METHODS
  Medical records of the patients with recurrent pleomorphic adenoma of the parotid gland referred to our institution were retrospectively reviewed. Before the second surgery, MR imaging had been performed in 15 patients. We retrospectively reevaluated and scored the MR imaging studies with particular attention paid to the location and number of the lesions and the remaining parotid gland tissue.
  
  
  RESULTS
  On the basis of imaging findings, eight patients underwent enucleation, superficial parotidectomy had been performed in four patients, and three patients underwent total parotidectomy. For our group, the lesions were multiple in 73.3% of patients.
  
  
  CONCLUSIONS
  To our knowledge, we present the first large series of imaging studies in recurrent pleomorphic adenoma of the parotid gland. Our findings show that recurrent pleomorphic adenomas are most likely to be multiple. Such multiplicity of lesions is a reliable diagnostic indicator of recurrent disease.
authors.affiliation: Department of Radiological Sciences, Center for the Health Sciences, UCLA School of Medicine, 650 Charles E. Young Dr., S., Los Angeles, CA 90095, USA.
authors.forename: Korgün
authors.initials: K
authors.lastname: Koral
authors.forename: James
authors.initials: J
authors.lastname: Sayre
authors.forename: Sunita
authors.initials: S
authors.lastname: Bhuta
authors.forename: Elliot
authors.initials: E
authors.lastname: Abemayor
authors.forename: Robert
authors.initials: R
authors.lastname: Lufkin
mesh_terms: D008949:Adenoma, Pleomorphic / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D018365:Neoplasm, Residual / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D010306:Parotid Gland / Q000473:pathology / Q000601:surgery; D010307:Parotid Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies