Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
권호 표지

Recurrent Pleomorphic Adenomas of the Parotid Gland

재발성 이하선 다형성 선종

  • Huh H. (Department of Surgery, Yonsei University College of Medicine) ;
  • Chung Woung-Yoon (Department of Surgery, Yonsei University College of Medicine) ;
  • Yoon Jong-Ho (Department of Surgery, Yonsei University College of Medicine) ;
  • Chang Hang-Seok (Department of Surgery, Yonsei University College of Medicine) ;
  • Park Cheong-Soo (Department of Surgery, Yonsei University College of Medicine)
  • 허혁 (연세대학교 의과대학 외과학교실) ;
  • 정웅윤 (연세대학교 의과대학 외과학교실) ;
  • 윤종호 (연세대학교 의과대학 외과학교실) ;
  • 장항석 (연세대학교 의과대학 외과학교실) ;
  • 박정수 (연세대학교 의과대학 외과학교실)
  • Published : 2003.05.01
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Surgical management of recurrent pleomorphic adenoma of the parotid gland has a considerable risk of facial nerve injury and a high re-recurrence rate. To obtain more insight into the issue of recurrent pleomorphic adenoma and more specifically to evaluate our experience and results of treatment, a retrospective study was carried out. Materials and Methods: During the period from 1989 to 2002, the medical records of 14 patients who underwent a operation for recurrent pleomorphic adenoma of the parotid gland were reviewed retrospectively. The initial operation for parotid tumor, clinical features of recurrence, reoperation after recurrence, po stop complication were analysed. Results: The male to female ratio was 6 : 9. Median age of the patients at the time of the initial operation was 33 years and at the time of the reoperation was 43 years. The median interval until recurrence was 105 months (6-252 months). The initial operations performed were excision or enucleation in 10 patients, superficial parotidectomy in 3 patients, total parotidectmy in 1 patients. The thirteen patients were underwent reoperation (8 superficial parotidectomies, 3 total parotidectomies, 1 neartotal parotidectomy, 1 wide excision). The facial nerve paralysis after the reoperation occured in 6 patients but all of them were recovered from 3 months to 1 year after surgery. Conclusion: In the management of pleomorphic adenoma of the parotid gland, excision or enucleation is to be avoided due to the higher recurrence rate and superficial or total parotidectomy with preservation of the facial nerve are to be preferred. Because the risk of facial nerve injury during operation for the recurrent tumor was higher than initial surgery, more careful surgical procedure is mandatory for preserving the facial nerve.

Keywords

References

  1. Donovan DT, Conler JJ : Capsular significance in parotid turnor surgery : Reality and myths of lateral lobectomy. Laryngoscope.1984 ; 97 :324-329
  2. Leverstein H, Wal van der JE, Tiwari RM, Waal van der I, Snow GB : Surgical mangement of 246 previously untreated pleo-morphic adenomas of the parotid gland. Br J Surg. 1997 :84:399-403
  3. Natving K, Soberg R : Relationship of intraoperative rupture of pleomorphic adenomas to recurrence : an 11-25 year follow-up study. Head Neck. 1994 ; 16: 213-217 https://doi.org/10.1002/hed.2880160302
  4. Henriksson G, Westuin KM, Carlso B, et al : Recurrent primary pleomorphic adenomas of salivary gland origin : intrasurgical rupture, histopathological features and pseudopodia. Cancer.1998 :82 :617-620
  5. Foote FW, Frazell EL : Tumors of the major salivary gland Cancer. 1953 :6 : 1065-1133
  6. Dawson AK :Radiation therapy in recurrent pleomorphic adenomas of the parotid. Int J Radiat Oncol Biol Phys.1988 : 16 : 819-821
  7. Maran AGD, Mackenzie IJ, Stanley RE : Recurrent plomorphic adenomas of the parotid gland. Arch Otolaryngol.1984 ; 110 : 167-171 https://doi.org/10.1001/archotol.1984.00800290031007
  8. Liu FF, Rotstein L, Davidson AJ, et al :Benign parotid adeno-mas :A review of the Princess Margaret Hospital experience. Head Neck.1995 ; 17 : 177-183 https://doi.org/10.1002/hed.2880170302
  9. Lindsey-Stevens K, Hovsley M : The treatment of pleomorphic adenomas by formal parotidectomy,Br J Srug. 1982 ; 69 : 1-3
  10. Niparko JK, Beauchamp ML, Krause CJ, Baker ST, Work WP : Surgical treatment of recurrent pleomorphic adenoma of the parotid gland. Arch Otolaryngol. 1986 ; 112 : 1180-1184 https://doi.org/10.1001/archotol.1986.03780110056007
  11. Zhang WDA, Liu SJ, Donoff BR, Guralnick W : A modified centripetal approach to parotidectomy. Journal of Oral and Maxillofacial Surgery. 1985 ; 43 : 14-19 https://doi.org/10.1016/S0278-2391(85)80007-0
  12. McMeese S, Fletcher GH : Tumors of the major and minor salivary glands. In :Laramore E, deitor. Radiation therapy of head and neck cancer. Berlin : Springer. 1989 : 181-196
  13. Barton J, Steven NJ, Gleave EN : Radiotherapy for pleomorphic adenoma of the parotid gland. Int J Radiat Oncol Biol Phys.1992 ; 2 : 925-928
  14. Stephens KL, Hovsley M : The treatment of pleomorphic adeno-mas by formal parotidectomy. Br J Surg. 1982 ; 69 : 1-3 https://doi.org/10.1002/bjs.1800690102
  15. Modan B, Baidatz D, Mart H, et al :Radiation-induced head and neck tumours. Lancet. 1974; i : 277-279
  16. Yugueros P, Goellner JR, Petty PM, Woods JE : Treating re-currence of parotid benign pleomorphic adenomas. Ann Plast Surg. 1998 ; 40 : 573-576 https://doi.org/10.1097/00000637-199806000-00001
  17. Eneroth CM, Blanck C, Jakobsson PA : Carcinoma in pleomorplic adenoma of the parotic gland. Acta Oto-laryngologica. 1968 ; 66 : 477-492 https://doi.org/10.3109/00016486809126313
  18. Jackson SR, Roland NJ, Clarke RW, Jones AS :Recurrent pleomorphic adenoma. J Laryngol Otol. 1993 ; 107 : 546-549 https://doi.org/10.1017/S0022215100123667
  19. Niparko JK, Beauchamp ML, Krause CJ, Baker SR, Work WP : Surgical treatment of recurrent pleomorphic adenoma of the parotid gland. Arch Otolaryngol Head Neck Surg. 1986 : 112 : 180-1184 https://doi.org/10.1001/archotol.1986.03780020060014
  20. Federspil PA, Federspil P, Schatzle W : Pleomorphe Parotisadenome und ihre Rezidive. HNO 1994 ; 42 : 28-35
  21. Woods IE, Chong GC, Beahrs OH : Experience with 1360 primary parotid tumors. Am J Surg. 1975 ; 130 : 460-462 https://doi.org/10.1016/0002-9610(75)90484-5
  22. Donovan DT, Conley J : Capsular sigmificance in parotid tumor surgery : Reality and myths of lateral lobectomy. laryngoscope. 1984 ; 94 : 324-329
  23. Myssiorek D, Ruah CB, Hybels RL : Recurrent pleomorphic adenomas of the parotid gland. Head Neck 1990 ; 12 : 332-336 https://doi.org/10.1002/hed.2880120410
  24. Conley J, Clairmont AA : Facial nerve in recurrent benign pleomorphic adenoma. Arch Otolaryngol. 1979 ;105 : 247-251 https://doi.org/10.1001/archotol.1979.00790170017004
  25. Work W, Batsakis JG, Bailey DG : Recurrent benign mixed tumor and the facial nerve. Arch Otolaryngol. 1976 ; 102 : 15-19 https://doi.org/10.1001/archotol.1976.00780060061006
  26. Fee WE Jr, Goffmet DR, Calcaterra TC : Recurrent mixed tumors of the parotid gland : Results of surgical therapy. Laryngoscope. 1978 ; 88 : 265-273 https://doi.org/10.1288/00005537-197802000-00008
  27. Glas AS, Verrney A, Hollema H, et al : Surgical treatment of recurrent pleomorphic adenoma of the parotid gland: a clinical analysis of 52 patients. Head Neck. 2001 ; 23 : 311-31 https://doi.org/10.1002/hed.1036
  28. Vermey A : Benign epithelial parotid tumors. Thesis. Groningen, 1989