title: Recurrent pleomorphic adenoma of the parotid gland: analysis of 108 consecutive patients.
abstract: BACKGROUND
  Surgery for recurrent parotid pleomorphic adenoma is a challenging problem.
  
  
  METHODS
  One hundred eight patients who underwent 134 reoperations for recurrent parotid pleomorphic adenoma (follow-up, 22 years) were evaluated for histopathologic features and risk factors for recurrence.
  
  
  RESULTS
  The number of reoperations for tumor recurrence ranged from 1 to 10. Twenty-seven patients (25%) developed permanent facial nerve weakness. The risks for clinically evident rerecurrence after 1, 5, and 15 years were 16%, 42%, and 75%, respectively. Female sex, young age at initial treatment, and enucleation instead of parotidectomy for treatment of the first recurrence were significant risk factors for rerecurrence. The mean number of recurrent tumor nodules was 26.
  
  
  CONCLUSIONS
  Surgery for recurrent parotid pleomorphic adenoma has a high rate of facial nerve morbidity. The chance of rerecurrence is high. Extended parotidectomy seems to be the best approach for the reoperation to reduce the risk of rerecurrence.
authors.affiliation: Clinic of Otorhinolaryngology, Head and Neck Surgery, University of Cologne, D-50924 Cologne, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Wittekindt
authors.forename: Kristina
authors.initials: K
authors.lastname: Streubel
authors.forename: Georg
authors.initials: G
authors.lastname: Arnold
authors.forename: Eberhard
authors.initials: E
authors.lastname: Stennert
authors.forename: Orlando
authors.initials: O
authors.lastname: Guntinas-Lichius
mesh_terms: D008949:Adenoma, Pleomorphic / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010307:Parotid Neoplasms / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012737:Sex Factors