[Recurrent pleomorphic adenomas of the parotid gland--treatment and outcome].
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.
Nazarian
Yaron
Y
Department of Oral and Maxillofacial Surgery, Barzilai Medical Center, Ashkelon, Israel.
Talmi
Yoav P
YP
Wolf
Michael
M
Horowitz
Zeev
Z
Bedrin
Lev
L
Pfeffer
Rephael
R
Kronenberg
Jona
J
D000236:Adenoma / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D010307:Parotid Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D012189:Retrospective Studies; D013997:Time Factors