title: Recurrent pleomorphic adenoma of the parotid gland: Institutional experience and review of the literature.
abstract: BACKGROUND
  Recurrent pleomorphic adenoma (PA) of the parotid gland is a challenging surgical issue with controversy regarding management and long term outcome.
  
  
  METHODS
  All patients who were operated for recurrent PA of the parotid gland between the years 1991 and 2013 were reviewed. Patient demographics, clinicopathologic variables, and operative details were collected retrospectively.
  
  
  RESULTS
  A total of 22 patients were operated for recurrent PA of the parotid gland. Mean interval between recurrences was 7 and 6 years for first recurrence and second recurrence, accordingly. Second recurrence was significantly influenced by younger age at initial treatment (P = 0.009). Only two patients (9%) with a recurrence developed facial nerve paralysis following surgery. Adjuvant radiotherapy was given to nine patients with no evidence of disease progression or recurrence. There were no cases of malignant transformation.
  
  
  CONCLUSIONS
  Recurrent PA of the parotid gland tends to occur in long intervals in a multifocal pattern. Adjuvant radiotherapy could be suggested as an alternative for surgery. J. Surg. Oncol. 2016;114:714-718. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel. ag.yasmin@gmail.com.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. ag.yasmin@gmail.com.
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Abu-Ghanem
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Aviram
authors.initials: A
authors.lastname: Mizrachi
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.|Department of Oncology, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: Aron
authors.initials: A
authors.lastname: Popovtzer
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Nora
authors.initials: N
authors.lastname: Abu-Ghanem
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Raphael
authors.initials: R
authors.lastname: Feinmesser
mesh_terms: D008949:Adenoma, Pleomorphic / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy* / Q000601:surgery; D010306:Parotid Gland / Q000601:surgery*; D010307:Parotid Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: facial nerve; parotidectomy; pleomorphic adenoma; radiotherapy; recurrence