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. 2009 Dec;2(4):193-7.
doi: 10.3342/ceo.2009.2.4.193. Epub 2009 Dec 31.

Clinical manifestations of recurrent parotid pleomorphic adenoma

Myung-Whan Suh  1 , J Hun Hah, Seong Keun Kwon, Young-Ho Jung, Tack-Kyun Kwon, Kwang Hyun Kim, Myung-Whun Sung
Affiliations

Clinical manifestations of recurrent parotid pleomorphic adenoma

Myung-Whan Suh et al. Clin Exp Otorhinolaryngol. 2009 Dec.

Abstract

Objectives: This study was undertaken to confirm the clinical characteristics of recurrent pleomorphic adenoma (RPA), and to identify those factors that affect the development of malignant transformation (MT) from RPA.

Methods: The medical records of 270 patients, who were operated upon for parotid PA, were retrospectively reviewed. The pathologic specimens of a selected series of 23 patients were reviewed for histologic subtype and microscopic multi-nodularity.

Results: Mean age of initial operation in RPA without MT (RPA(-MT)) group was significantly lower than that of primary PA group. Mean age of the revision operation in RPA with MT (RPA(+MT)) group was significantly greater than that of RPA(-MT) group. Mean interval from operation to recurrence shortened after each revision operation. The risk of MT and additional recurrence increased significantly with recurrence. In RPA(-MT) group tumor recurrence occurred in 21.4% of patients despite a clear resection margin.

Conclusion: The risk factors for MT may be an age of over 45 yr and multiple recurrences. However, younger patients are more at risk of recurrence. A clear resection margin cannot guarantee a cure in RPA, and it seems that parotid pleomorphic adenomas slowly gain malignant characteristics after repeated recurrences.

Keywords: Parotid glancl; Pleomorphic adenoma; Recurrence; Risk factor.

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Figures

Fig. 1
Fig. 1
Progressive changes in clinical manifestations after multiple recurrences. Duration between revision operations and subsequent recurrences tended to shorten as the number of previous revisions increased (P=0.06). The percentage of patients with a malignant tumor at revision surgery was higher than at initial operation (P=0.04). The general trend toward an increased risk of further recurrence after repeated surgery was significant (P<0.01), despite our finding of a lower risk at the third than at the second operation.
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References

    1. Hanna EY, Lee S, Fan CY, Suen JY. Benign neoplasms of the salivery glands. In: Cummings CW, Flint PW, editors. Cummings Otolaryngology: Head & Neck Surgery. 4th ed. Philadelphia: Mosby; 2005. pp. 1348–1377.
    1. Suh MW, Hah JH, Lee KB, Kwon SK, Jung YH, Sung MW, et al. Immunohistochemical characteristics of primary and recurrent pleomorphic adenoma. Korean J Head Neck Oncol. 2005 Nov;21(2):146–150.
    1. Junquera L, Alonso D, Sampedro A, Fresno F, Albertos JM, Lopez-Arranz JS. Pleomorphic adenoma of the salivary glands: prospective clinicopathologic and flow cytometric study. Head Neck. 1999 Oct;21(7):652–656. - PubMed
    1. Bankamp DG, Bierhoff E. Proliferative activity in recurrent and non-recurrent pleomorphic adenoma of the salivary glands. Laryngorhinootologie. 1999 Feb;78(2):77–80. - PubMed
    1. Leverstein H, Tiwari RM, Snow GB, van der Wal JE, van der Waal I. The surgical management of recurrent or residual pleomorphic adenomas of the parotid gland: analysis and results in 40 patients. Eur Arch Otorhinolaryngol. 1997;254(7):313–317. - PubMed