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We report an up-to-date assessment of the epidemiology of pleomorphic adenoma. We found an increasing incidence and low recurrence rate compared with previous studies. The risk of Ca-ex-PA for patients with recurrent pleomorphic adenoma was low compared to the literature. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1364-E1369, 2016.

Background The patterns of regional metastasis in adenoid cystic carcinoma (ACC) of the head and neck and its association with outcome is not established. Methods We conducted a retrospective multicentered multivariate analysis of 270 patients who underwent neck dissection. Results The incidence rate of neck metastases was 29%. The rate observed in the oral cavity is 37%, and in the major salivary glands is 19% (p = .001). The rate of occult nodal metastases was 17%. Overall 5-year survival rates were 44% in patients undergoing therapeutic neck dissections, and 65% and 73% among those undergoing elective neck dissections, with and without nodal metastases, respectively (p = .017). Multivariate analysis revealed that the primary site, nodal classification, and margin status were independent predictors of survival. Conclusion Our findings support the consideration of elective neck treatment in patients with ACC of the oral cavity.

Considerable benefit to the patient may result from the cautious use of FNAB of lesions of the salivary gland. The close co-operation between pathologist and surgeon can improve individual treatment.

Although perineural invasion has no impact on survival, intraneural invasion is an independent predictor of poor prognosis. Recognition of intraneural invasion may help optimize treatment of patients with head and neck ACC.

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