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Recurrent Pleomorphic Adenoma: Results of Surgical Treatment

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Recurrent parotid pleomorphic adenoma surgery increases the risk of facial nerve injury, and there is also a risk of ulterior recurrence.

Methods

Postoperative results from 62 consecutive patients operated for recurrent pleomorphic adenoma were analyzed. It was the first recurrence for 49 patients (79%), the second or more for 13 patients (21%).

Results

Total parotidectomy was performed in 69.4% of cases. Skin resection was performed in 47 patients (75.8%). Resection of a facial nerve branch was performed in seven patients (11.3%). Pathologic examination findings revealed carcinoma ex pleomorphic adenoma in 10/62 cases (16.1%) and microscopic multinodular disease in 39 patients (62.9%). Nine patients had preoperative facial palsy, 95% had postoperative facial paralysis ≥grade II (House–Brackmann scale), and 11.3% still had ≥grade III facial palsy after 1 year. Six patients developed another recurrence after our intervention (9.68%). Moreover, carcinoma was discovered after a new intervention in 40% of these patients. Initial partial parotid surgery [hazard ratio (HR) = 8.477, P = 0.008], microscopic multinodular recurrent disease (HR = 11.717, P = 0.005), and ≥1 recurrence number (HR = 10.608, P = 0.01) were associated with increased risk of ulterior recurrence.

Conclusion

Surgery is recommended in pleomorphic adenoma recurrence because of the high rate of carcinoma ex pleomorphic adenoma (16.1%). Nevertheless, a definitive facial paralysis ≥grade III rate of 11.3% is reported after multiple nerve dissection. New recurrence after surgery is less frequent if the initial treatment for pleomorphic adenoma is total parotidectomy.

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Acknowledgment

The authors stated that they do not have any commercial interest in the subject of this study and the source of any financial or material support.

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Authors and Affiliations

  1. Department of Head and Neck Surgery, CHU, Montpellier, France

    Marc Makeieff MD, PhD, Pierfrancesco Pelliccia MD, Sebastien Arnaud MD, Cartier César MD, Renaud Garrel MD, PhD, Louis Crampette MD, PhD & Bernard Guerrier MD

  2. Department of Medical Information, CHU, Montpellier, France

    Flavie Letois MD & Grégoire Mercier MD

Authors
  1. Marc Makeieff MD, PhD
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  2. Pierfrancesco Pelliccia MD
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  3. Flavie Letois MD
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  4. Grégoire Mercier MD
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  5. Sebastien Arnaud MD
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  6. Cartier César MD
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  7. Renaud Garrel MD, PhD
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  8. Louis Crampette MD, PhD
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  9. Bernard Guerrier MD
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Corresponding author

Correspondence to Marc Makeieff MD, PhD.

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Makeieff, M., Pelliccia, P., Letois, F. et al. Recurrent Pleomorphic Adenoma: Results of Surgical Treatment. Ann Surg Oncol 17, 3308–3313 (2010). https://doi.org/10.1245/s10434-010-1173-2

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  • DOI: https://doi.org/10.1245/s10434-010-1173-2

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