title: Multinodular neck recurrence of parotid gland pleomorphic adenoma: a case report.
abstract: BACKGROUND
  Pleomorphic adenoma is the most common neoplasm of the parotid gland. It is a benign tumor composed of epithelial and myoepithelial cells arranged in various morphological patterns. The most common reasons contributing to a recurrent disease are obvious or underestimated tumor spillage, incomplete excision, and violation of the pseudocapsule of the tumor.
  
  
  METHODS
  This article presents a case of gross multinodular recurrence of a parotid gland pleomorphic adenoma in a 38-year-old female patient. Upon clinical examination of the homolateral neck, multiple, painless, well-defined, palpable, nontender masses and subcutaneous nodules of the right parotid and homolateral neck region were revealed. The patient was treated with surgery and subsequent radiation therapy. Histologic examination of the resected specimen was suggestive of a recurrent pleomorphic adenoma disease. There were no signs of malignant transformation in the specimen. The diagnostic procedure followed, and management of the patient is outlined in the paper.
  
  
  CONCLUSIONS
  Pleomorphic adenoma is the most common tumor of the parotid gland. In spite of being a benign neoplasm, inadequate management of the lesion may lead to problems such as local recurrence or malignant transformation. Management of recurrent tumors is challenging because the probability of subsequent recurrence increases with each recurrent episode, thus making local control increasingly difficult and damage to the facial nerve more likely.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Evangelismos General Hospital, University of Athens Dental School, 45-47 Ipsilantou Street, Athens 10676, Greece.
authors.forename: Nick
authors.initials: N
authors.lastname: Papadogeorgakis
authors.forename: Evagelos F
authors.initials: EF
authors.lastname: Kalfarentzos
authors.forename: Vassilis
authors.initials: V
authors.lastname: Petsinis
authors.forename: Eleni
authors.initials: E
authors.lastname: Parara
authors.forename: Maria-Emmanouela
authors.initials: ME
authors.lastname: Kopaka
mesh_terms: D008949:Adenoma, Pleomorphic / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D000328:Adult; D044963:Biopsy, Fine-Needle; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D010306:Parotid Gland / Q000473:pathology / Q000601:surgery; D010307:Parotid Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D018714:Radiotherapy, Adjuvant