[Metastasis of a pleomorphic adenoma].
METHODS
A 53-year-old man underwent a right parotidectomy in 1993 for a pleomorphic adenoma. The tumor relapsed locally, three years later, imposing a reoperation. The histology was unchanged. Two years later, the excision of a new local recurrence revealed a histological evolution with intravascular emboli, some cellular atypia and some mitoses. One year later, in a context of cephalgia and amaurosis, metastases were discovered on the calvarial skull. These were treated by radiotherapy. The patient died of a cerebral hemorrhage related to a history of familial autoimmune thrombocytopenia.


CONCLUSIONS
Regional and systemic metastases of pleomorphic adenomas are exceptional. The local recurrence is characteristic of metastatic forms of pleomorphic adenomas; it occurs in 90% of the cases. No clinical or histological criterion allows distinguishing between recurrent metastatic forms and non-recurrent metastatic pleomorphic adenomas. The metastatic mechanism is not clearly elucidated yet. The best treatment for metastases of a pleomorphic adenoma is surgical excision. The recurrence after a complete surgical excision is rare and the prognosis excellent.
Service de stomatologie et de chirurgie maxillofaciale, centre hospitalier de Meaux, 6-8, rue Saint-Fiacre, 77104 Meaux cedex, France. ekenza@yahoo.com
K
K
Eladioui
A
A
Ntima
P
P
Noublanche
N
N
Cucherousset
A
A
Attar
D008949:Adenoma, Pleomorphic / Q000473:pathology*; D017809:Fatal Outcome; D005500:Follow-Up Studies; D005624:Frontal Bone / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D010294:Parietal Bone / Q000473:pathology; D010307:Parotid Neoplasms / Q000473:pathology*; D012888:Skull Neoplasms / Q000556:secondary*; D013701:Temporal Bone / Q000473:pathology