Etiology and management of recurrent parotid pleomorphic adenoma

Laryngoscope. 2015 Apr;125(4):888-93. doi: 10.1002/lary.24964. Epub 2014 Oct 7.

Abstract

The objective of this review study was to encompass the relevant literature and current best practice options for this challenging, sometimes incurable problem. The source of the data was Ovid MEDLINE from 1946 to 2014. Review methods consisted of articles with clinical correlates. The most important cause of recurrence is enucleation with rupture and incomplete tumor excision at operation. Incomplete pseudocapsule, extracapsular extension, pseudopods of pleomorphic adenoma tissue, and satellite pleomorphic beyond the pseudocapsule are also likely linked to recurrent pleomorphic adenoma. Most recurrent pleomorphic adenoma are multinodular. Magnetic resonance imaging is the imaging study of choice for recurrent pleomorphic adenoma. Nerve integrity monitoring may reduce morbidity for recurrent pleomorphic adenoma. Treatment of recurrent pleomorphic adenoma must be individualized. Total parotidectomy, given the multicentricity of recurrent pleomorphic adenoma, is appropriate in many patients, but may be inadequate to control recurrent pleomorphic. There is accumulating evidence from retrospective series that postoperative radiation therapy results in significantly better local control.

Keywords: benign mixed tumor; etiology; management; pleomorphic adenoma; recurrence.

Publication types

  • Review

MeSH terms

  • Adenoma, Pleomorphic / pathology
  • Adenoma, Pleomorphic / radiotherapy
  • Adenoma, Pleomorphic / surgery*
  • Adult
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Neoplasm Invasiveness / pathology
  • Neoplasm Recurrence, Local / etiology*
  • Neoplasm Recurrence, Local / radiotherapy
  • Neoplasm Recurrence, Local / surgery*
  • Neoplasm Staging
  • Parotid Gland / surgery
  • Parotid Neoplasms / pathology
  • Parotid Neoplasms / radiotherapy
  • Parotid Neoplasms / surgery*
  • Prognosis
  • Radiotherapy, Adjuvant
  • Risk Assessment
  • Salivary Gland Neoplasms / pathology
  • Salivary Gland Neoplasms / radiotherapy
  • Salivary Gland Neoplasms / surgery*
  • Treatment Outcome

Supplementary concepts

  • Salivary Gland Adenoma, Pleomorphic