An analysis of the treatment of 114 patients with recurrent pleomorphic adenomas of the parotid gland

Recurrent Parotid Pleomorphic Adenomas: Our Clinical Experience

“…Age and gender were not considered as prognostic factors in terms of the cause of recurrent disease in the series of 114 cases of Renehan et al (12) and in the series of 31 cases of Carew et al (13). However; in some studies, the female gender has been identified as a risk factor for recurrent disease (7, 10).…”

“…When evaluated in terms of the surgeries performed for recurrent parotid pleomorphic adenomas, this ratio was found to be significantly increased, temporarily to 90-100% and permanently to 11.3-40% (9). This rate increases with the number of revision surgeries performed, and the high complication rate has been attributed to the inability to distinguish the scar tissue from the facial nerve (9,12,14). In some studies, it has been observed that intraoperative facial nerve monitoring shortens the operation time, reduces the risk of permanent facial nerve paralysis, and shortens the postoperative recovery time of facial nerve motor functions (15,16).…”

“…Various treatment modalities have been reported, ranging from totally untreated patients to radical parotidectomies, in which the facial nerve branches are sacrificed, and adjuvant radiotherapy applied (4,7,(10)(11)(12). In our study, our approach to recurrent pleomorphic adenomas was discussed with review of the literature by discussing the clinical and surgical characteristics and follow-up results of 11 patients who had recurrence at an average of 11.9 years after the first surgery.…”

Imaging Characteristics of Recurrent Pleomorphic Adenoma of the Parotid Gland

“…4 Recurrences usually occur within the first 10 years following initial surgery, and rarely, recurrences have been reported as long as 45 years after the initial surgery. [6][7][8] The major risk factors for recurrence of benign mixed tumors include enucleation and rupture of the tumor at the time of surgical resection. 9 Other associations for increased risk of recurrence include hypocellular tumors, 10 younger age at initial presentation, 11 female patients, 12 and tumors that have already recurred.…”

RE: Pleomorphic adenomas: Post-operative radiotherapy is unnecessary following primary incomplete excision: A retrospective review

“…The first recurrence has been reported twenty years after initial treatment and facial palsy complicates up to a third of patients undergoing surgery, although it is frequently temporary. [2][3][4] However, surgery in recurrence carries a higher risk of facial nerve injury, 5 which is more likely to impact on the group who did not receive post-operative radiotherapy. Moreover, pleomorphic adenoma (PA) recurrence can involve the skull base or old scars making adequate salvage surgery difficult and often requiring loco-regional reconstruction adding a layer of complexity and surgical morbidity.…”