Postoperative complications after removal of pleomorphic adenoma from the parotid gland: A long-term follow up of 297 patients from 2002 to 2016 and a review of publications

Bonavolontà, Paola; Orabona, Giovanni Dell’Aversana; Maglitto, Fabio; Abbate, Vincenzo; Committeri, Umberto; Salzano, Giovanni; Improta, Giovanni; İaconetta, Giorgio; Califano, Luigi

doi:10.1016/j.bjoms.2019.08.008

Cited by 33 publications

(41 citation statements)

References 24 publications

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“…Since the present case was that of a PA involving superficial parotid only (Figures 1 and 2 ), the patient was surgically managed through ECD ( Figure 3 ), avoiding any iatrogenic damage to the facial nerve ( Figure 5 ). The surgical techniques for resecting PA have evolved over the last century and have essentially focused on preserving anatomic and functional integrity of the facial nerve and its branches [ 1 , 7 ]. While intracapsular removal was advocated, during the late 19 th and early 20 th centuries in an attempt to avoid facial nerve injury, the technique was abandoned due to its high risk of recurrence (≥45%) [ 1 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…The surgical techniques for resecting PA have evolved over the last century and have essentially focused on preserving anatomic and functional integrity of the facial nerve and its branches [ 1 , 7 ]. While intracapsular removal was advocated, during the late 19 th and early 20 th centuries in an attempt to avoid facial nerve injury, the technique was abandoned due to its high risk of recurrence (≥45%) [ 1 , 7 ]. This leads to the popularity of SP, associated with a very low recurrence rate (≤2%), but still carrying a risk of facial nerve injury, Frey syndrome, and loss of facial contour [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

“…Depending upon their size and depth of involvement, parotid PA is surgically managed either by superficial parotidectomy (SP), extracapsular dissection (ECD), or total parotidectomy (TP). All of the above procedures carry the risk of postoperative facial nerve paralysis and Frey's syndrome [ 1 , 7 ]. Recurrence is usually associated with inadequate clearance and incomplete removal of pseudocapsule, and malignant transformation has been reported with large, long-standing PA [ 4 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Giant Parotid Pleomorphic Adenoma with Atypical Histological Presentation and Long-Term Recurrence-Free Follow-Up after Surgery: A Case Report and Review of the Literature

Alkindi

Ramalingam

Hakeem

et al. 2020

Case Reports in Dentistry

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Salivary gland tumors (SGT) comprise 3% of all head and neck tumors, are mostly benign, and arise frequently in the parotid gland. Pleomorphic adenoma (PA) is the commonest SGT, representing 60-70% of all benign parotid tumors. Clinically, parotid PA presents as irregular, lobulated, asymptomatic, slow-growing preauricular mass, involving both superficial and deep lobes, and could grow to gigantic proportions. Histologically, PA has epithelial and mesenchymal elements in chondromyxoid matrix and is managed surgically. Based on a review of 43 cases reported in English literature since 1995, giant parotid PA is reported as large as 35 cm (diameter) and 7.3 kg (resected weight). Although rare, 10 cases of malignant transformation were reported in the review. Surgical management included extracapsular dissection (ECD), superficial parotidectomy, and total parotidectomy for benign tumors, and adjuvant radiation or chemotherapy for malignant tumors. We further present the case of a 36-year-old healthy male with slow-growing and asymptomatic giant parotid PA, of 4-year duration. The patient presented with firm, lobulated preauricular swelling, provisionally diagnosed as PA based on radiographic and cytological findings. The tumor was resected through ECD, and the patient had uneventful postoperative recovery and a 7-year recurrence-free follow-up period. Histological examination revealed epimyoepithelial proliferation punctuated by chondromyxoid areas, with extensive squamous metaplasia and keratin cysts. To the best of knowledge from indexed literature, giant parotid PA is rarely reported in Saudi Arabia. In addition to its rarity, this case is reported for its benign nature despite atypical histological presentation, successful surgical management without complications, and long-term recurrence-free follow-up. Based on this report, clinicians must be aware of atypical histological presentations associated with PA and plan suitable surgical management and follow-up to avoid morbidity. Nevertheless, attempts must be made to diagnose and manage these lesions at an early stage and before they reach gigantic proportions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Giant Parotid Pleomorphic Adenoma with Atypical Histological Presentation and Long-Term Recurrence-Free Follow-Up after Surgery: A Case Report and Review of the Literature

Alkindi

Ramalingam

Hakeem

et al. 2020

Case Reports in Dentistry

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“…Pleomorphic adenoma often has a characteristic appearance in magnetic resonance images, presenting homogeneous hyperintensity in T2, well-to Tiago et al 9 , facial nerve paresis is 2.3 times greater when total parotidectomy is performed, when compared to superficial parotidectomy. In addition to facial nerve involvement, another complication that can be found is Frey's Syndrome, which is clinically presented with sweating and erythema in the parotid region, caused by interruption of parasympathetic post-ganglional fibers of the glossopharyngeal nerve that travel through the auriculotemporal nerve that infuses the parotid region 10,19,28 .…”

Section: Discussionmentioning

confidence: 99%

“…Within this group, pleomorphic adenoma (PA), the most common benign neoplasm of the major salivary glands (GSMA) and minor ones (GSMe) stand out 3,8,9 . This lesion is described as a slow evolution neoplasm, well delimited, painless, apparently encapsulated, that rarely exceeds 5 cm in its largest diameter 3,5,10 . The PA capacity to undergo recurrences and malignant transformation has been reported by the literature, especially in cases where there has been incomplete surgical excision, multiple local recurrences and in tumors that have remained for long periods without diagnosis and treatment [11][12][13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

Conservative Surgical Approach to Pleomorphic Adenoma in Parotid Gland: Case Report

et al. 2020

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Abstract Pleomorphic adenoma is a benign neoplasm of the salivary glands that affects most frequently females in the fourth and sixth decade of life. As it is usually an asymptomatic lesion, it is diagnosed upon routine physical examination. Treatment consists of surgical removal with partial or total involvement of the parotid gland. Conservative enucleation is the least invasive surgical option for this type of lesion. The present work aimed at reporting a case of pleomorphic adenoma of the parotid gland with eight years of evolution. The tumor was treated conservatively. Patient has been followed for sixth months, and no sensory alterations, fistulae, clinical signs of recurrence, nor any other alterations have been observed so far. Due to the lesion benign nature, an evolution with favorable prognosis is expected. Keywords: Adenoma. Neoplasms. Salivary Glands. Resumo O Adenoma pleomórfico é uma neoplasia benigna de glândulas salivares, que acomete com maior frequência pessoas do sexo feminino entre a quarta e sexta década de vida. Por se tratar de uma lesão muitas vezes assintomática, geralmente é descoberta através do exame físico de rotina. O seu tratamento consiste em remoção cirúrgica podendo envolver ou não a glândula parótida de maneira parcial ou total. A enucleação conservadora é a modalidade cirúrgica menos invasiva para este tipo de lesão. O presente trabalho tem por objetivo relatar um caso de adenoma pleomórfico em glândula parótida com oito anos de evolução. O tumor foi tratado de maneira conservadora. A paciente está sendo acompanhada há 6 meses e não foram observados até momento alterações sensoriais, fistulas, indícios clínicos de recidiva ou qualquer outra alteração. Devido ao caráter benigno da lesão, espera-se evolução com prognóstico favorável. Palavras-chave: Adenoma. Neoplasias. Glândulas Salivares.

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Complications of Salivary Gland Surgery

Turner

2021

Salivary Gland Pathology

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Postoperative complications after removal of pleomorphic adenoma from the parotid gland: A long-term follow up of 297 patients from 2002 to 2016 and a review of publications

Cited by 33 publications

References 24 publications

Giant Parotid Pleomorphic Adenoma with Atypical Histological Presentation and Long-Term Recurrence-Free Follow-Up after Surgery: A Case Report and Review of the Literature

Giant Parotid Pleomorphic Adenoma with Atypical Histological Presentation and Long-Term Recurrence-Free Follow-Up after Surgery: A Case Report and Review of the Literature

Conservative Surgical Approach to Pleomorphic Adenoma in Parotid Gland: Case Report

Complications of Salivary Gland Surgery

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