Skip to main content
SpringerLink
Log in

The surgical management of recurrent or residual pleomorphic adenomas of the parotid gland. Analysis and results in 40 patients

  • Original Paper
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

From 1974 to 1995, 40 patients were treated surgically at the University Hospital Vrije, Universiteit Amsterdam for recurrent or residual pleomorphic adenomas of the parotid gland after previous surgery. The median interval between the initial procedure and surgery for the recurrence was 122 months. Eleven patients had one or more attempts to resect tumor recurrences prior to referral. During reoperation at this institution it was decided to refrain from tumor resection in three patients. Tumor control in two of these patients was achieved using radiotherapy. In the third patient a “wait-and-see” policy was adopted. The other 37 patients underwent en bloc surgical excisions of their tumor and/or previously incised tissues. Among the 36 patients operated for histopathologically benign disease, 16 received postoperative radiotherapy (to 6500 cGy). None developed a further recurrence, the median follow-up being 106 months. Only one of these patients experienced permanent segmental facial nerve paralysis. Malignant transformation of tumor occurred in two patients. One of these patients died of locoregional disease after surgery and radiotherapy. Radical tumor resection was deferred in the other patient, with tumor control achieved using radiotherapy (7000 cGy). However, since recurrent disease tends to be multifocal in origin, prolonged routine follow-up is required.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bailey H (1941) Treatment of tumours of the parotid gland with special reference to total parotidectomy. Br J Surg 28:337–346

    Article  Google Scholar 

  2. Bailey H (1947) Parotidectomy: indications and results. BMJ 1:404–407

    Article  Google Scholar 

  3. Barton J, Slevin NJ, Gleave EN (1992) Radiotherapy for pleomorphic adenoma of the parotid gland. Int J Radiat Oncol Biol Phys 22:925–928

    PubMed  CAS  Google Scholar 

  4. Batsakis JG. (1979) Tumors of the major salivary glands. In: Tumors of the head and neck, 2nd edn. Williams and Wilkins, Baltimore, pp 1–76

    Google Scholar 

  5. Boles R, Johns ME, Batsakis JG (1973) Carcinoma in pleomorphic adenomas of salivary glands. Ann Otol Rhinol Laryngol 82:684–90

    PubMed  CAS  Google Scholar 

  6. Buchman G, Stringer SP, Mendenhall WM, Parsons JT, Jordan JR, Cassisi NJ (1994) Pleomorphic adenoma: effect of tumor spill and inadequate resection on tumor recurrence. Laryngoscope 104:1231–1234

    PubMed  CAS  Google Scholar 

  7. Conley JJ (1988) Problems with reoperation of the parotid gland and facial nerve. Arch Otolaryngol Head Neck Surg 99:480488

    Google Scholar 

  8. Conley J, Clairmont AA (1979) Facial nerve in recurrent pleomorphic adenoma of the parotid gland. Arch Otolaryngol 105:247–251

    PubMed  CAS  Google Scholar 

  9. Dawson AK, Orr JA (1985) Long term results of local excision and radiotherapy in pleomorphic adenoma of the parotid. Int J Radiat Oncol Biol Phys 11:451–455

    PubMed  CAS  Google Scholar 

  10. Duck SW, McConnel FMS (1993) Malignant degeneration of pleomorphic adenoma - clinical implications. Am J Otol 14:175–178

    Article  CAS  Google Scholar 

  11. Eneroth CM, Zetterberg A (1974) A malignancy in pleomorphic adenoma. Acta Otolaryngol (Stockh) 77:426–432

    CAS  Google Scholar 

  12. Fee WE, Goffinet DR, Calceterra TC (1978) Mixed tumours of the parotid gland, results of surgical therapy. Laryngoscope 88:265–273

    PubMed  Google Scholar 

  13. Fleming WB (1987) Recurrent pleomorphic adenoma of the parotid. Aust NZ J Surg 57:173–176

    CAS  Google Scholar 

  14. Freling NJM. MRI of parotid gland tumors (1991) Thesis, University of Groningen

  15. Hanna DC, Dickason WL, Richardson GS, Gaisford JC (1976) Management of recurrent salivary gland tumors. Am J Surg 132:453–458

    Article  PubMed  CAS  Google Scholar 

  16. Jackson SR, Roland NJ, Clarke RW, Jones AS (1993) Recurrent pleomorphic adenoma. J Laryngol Otol 107:546–549

    PubMed  CAS  Google Scholar 

  17. Janes RM (1940) The treatment of tumours of the salivary gland by radical excision. Can Med Assoc J 43:554–559

    Google Scholar 

  18. Kirkbride P, Liu FF, Wax MK (1992) Radiation-induced hearing impairment — a pilot study in patients treated for malignant tumours. Br J Radiol 65:833–835

    Article  PubMed  CAS  Google Scholar 

  19. Leverstein H, Wal JE van der, Tiwari RM, Waal I van der, Snow GB (1997) Developments and results in the surgical management of 246 previously untreated parotid gland pleomorphic adenomas. Br J Surg 84:399–403

    Article  PubMed  CAS  Google Scholar 

  20. Maran AGD, Mackenzie IJ, Stanley RE (1984) Recurrent pleomorphic adenomas of the parotid gland. Arch Otolaryngol 110:167–171

    PubMed  CAS  Google Scholar 

  21. Maynard JD (1988) Management of pleomorphic adenoma of the parotid. Br J Surg 75:305–308

    Article  PubMed  CAS  Google Scholar 

  22. Myssiorek D, Ruah CB, Hybels RL (1990) Recurrent pleomorphic adenomas of the parotid gland. Head Neck 12:332–336

    Article  PubMed  CAS  Google Scholar 

  23. Niparko JK, Beauchamp ML, Krause ChJ, Baker SR, Work WP (1986) Surgical treatment of recurrent pleomorphic adenoma of the parotid gland. Arch Otolaryngol Head Neck Surg 112:1180–1184

    PubMed  CAS  Google Scholar 

  24. Olsen KD, Daube JR (1994) Intraoperative monitoring of the facial nerve: an aid in the management of parotid gland recurrent pleomorphic adenomas. Laryngoscope 104: 229–232

    Article  PubMed  CAS  Google Scholar 

  25. Philips PP, Olsen KD (1995) Recurrent pleomorphic adenoma of the parotid gland: report of 126 cases and a review of the literature. Ann Otol Rhinol Laryngol 104:100–104

    Google Scholar 

  26. Rodriguez-Bigas MA, Sako K, Razack MS, Shedd DP, Bakamjian VY (1991) Benign parotid tumors: a 24 year experience. J Surg Oncol 46:159–161

    Article  PubMed  CAS  Google Scholar 

  27. Samson MJ, Metson R, Wang CC, Montgomery WM (1991) Preservation of the facial nerve in the management of recurrent pleomorphic adenoma. Laryngoscope 101: 1060–1062

    Article  PubMed  CAS  Google Scholar 

  28. Schot LJ, Hilgers FJM, Keus RB, Schouwenburg PF, Dreschler WA (1992) Late effects of radiotherapy on hearing. Fur Arch Otorhinolaryngol 249:305–308

    CAS  Google Scholar 

  29. Stevens KL, Hobsley M (1982) The treatment of pleomorphic adenomas by formal parotidectomy. Br J Surg 69: 1–3

    Article  PubMed  CAS  Google Scholar 

  30. Thackray AC, Sobin LH (1972) WHO International Histological classification of tumours, no.7. Histological typing of salivary gland tumours. World Health Organization, Geneva

    Google Scholar 

  31. Vermey A (1989) Benign epithelial parotid tumors. Van Gorkum, Assen Maastricht

    Google Scholar 

  32. Watkin GT, Hobsley M (1986) Should radiotherapy be used routinely in the management of benign parotid tumours? Br J Surg 73:601–603

    Article  PubMed  CAS  Google Scholar 

  33. Watkin GT, Hobsley M (1986) Influence of local surgery and radiotherapy on the natural history of pleomorphic adenomas. Br J Surg 73:74–76

    Article  PubMed  CAS  Google Scholar 

  34. Woods JE (1985) Parotidectomy versus limited resection for benign parotid masses. Am J Surg 149:749–750

    Article  PubMed  CAS  Google Scholar 

  35. Woods JE, Weiland LH, Chong GC, Irons GB (1977) Pathology and surgery of primary tumors of the parotid. Surg Clin North Am 57:565–573

    PubMed  CAS  Google Scholar 

  36. Work W, Batsakis JG, Bailey D (1976) Recurrent benign mixed tumor and the facial nerve. Arch Otolaryngol 102:15–19

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, University Hospital Vrije, Universiteit, Amsterdam, De Boelelaan 1117, 1081, HV Amsterdam, The Netherlands

    H. Leverstein, R. M. Tiwari & G. B. Snow

  2. Department of Oral and Maxillofacial Surgery/Pathology, University Hospital Vrije, Universiteit Amsterdam, De Boelelaan 1117, 1081, HV Amsterdam, The Netherlands

    J. E. van der Wal & I. van der Waal

Authors
  1. H. Leverstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. M. Tiwari
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. B. Snow
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. E. van der Wal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. I. van der Waal
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Leverstein, H., Tiwari, R.M., Snow, G.B. et al. The surgical management of recurrent or residual pleomorphic adenomas of the parotid gland. Analysis and results in 40 patients. Eur Arch Otorhinolaryngol 254, 313–317 (1997). https://doi.org/10.1007/BF02630721

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02630721

Key words

Search

Navigation