Recurrent benign parotid tumours: the lesson not learnt yet? . 1998

N Patel, and A Poole
Department of Head and Neck Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia. npatel@mail.usyd.edu.au

BACKGROUND To study the behaviour of recurrent benign parotid tumours, recurrence characteristics and problems faced with the removal of these lesions. METHODS We reviewed the charts of the work of a single surgeon between 1971 and 1996. RESULTS There were 24 patients (13 women, 11 men) with a mean age of 44 years at re-operation. Mean follow-up period was 10 years (range 1-22 years). There were 21 recurrent pleomorphic adenomas, two monomorphic adenomas and one patient with recurrent oncocytoma. Nine patients had solitary recurrence with a mean size of 14 mm, 15 patients had multiple recurrences with a mean size of 8 mm. There was malignant transformation of a previously benign lump in one patient. Three patients presented with a second or third recurrence. Overall facial nerve paralysis was 53% (38% temporary and 15% permanent). Frey's syndrome occurred in four patients (17%). CONCLUSIONS Recurrent benign parotid tumours are uncommon if superficial parotidectomy (SP) is the performed initially; recurrence rates are between 0-4%. The recurrences are usually slow growing and require lengthy follow-up. Pre-operative diagnosis of a lump in the region of previous excision is useful in treatment planning. Malignant transformation in previous benign lump should be considered and fine needle aspiration biopsy may help in diagnosis. Facial nerve injury is more likely if the tumour is deep, in multiple sites or involves extensive scar tissue. Radiotherapy is controversial, it should be considered if there has been tumour spillage following re-operation.

UI MeSH Term Description Entries
D008297 Male Males
D008949 Adenoma, Pleomorphic A benign, slow-growing tumor, most commonly of the salivary gland, occurring as a small, painless, firm nodule, usually of the parotid gland, but also found in any major or accessory salivary gland anywhere in the oral cavity. It is most often seen in women in the fifth decade. Histologically, the tumor presents a variety of cells: cuboidal, columnar, and squamous cells, showing all forms of epithelial growth. (Dorland, 27th ed) Mixed Salivary Gland Tumor,Salivary Gland Tumor, Mixed,Syringoma, Chondroid,Adenomas, Pleomorphic,Chondroid Syringoma,Chondroid Syringomas,Pleomorphic Adenoma,Pleomorphic Adenomas,Syringomas, Chondroid
D009364 Neoplasm Recurrence, Local The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site. Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D010243 Paralysis A general term most often used to describe severe or complete loss of muscle strength due to motor system disease from the level of the cerebral cortex to the muscle fiber. This term may also occasionally refer to a loss of sensory function. (From Adams et al., Principles of Neurology, 6th ed, p45) Palsy,Plegia,Todd Paralysis,Todd's Paralysis,Palsies,Paralyses,Paralysis, Todd,Paralysis, Todd's,Plegias,Todds Paralysis
D010307 Parotid Neoplasms Tumors or cancer of the PAROTID GLAND. Cancer of Parotid,Parotid Cancer,Cancer of the Parotid,Neoplasms, Parotid,Cancer, Parotid,Cancers, Parotid,Neoplasm, Parotid,Parotid Cancers,Parotid Neoplasm
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D005154 Facial Nerve The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and SALIVARY GLANDS, and convey afferent information for TASTE from the anterior two-thirds of the TONGUE and for TOUCH from the EXTERNAL EAR. Cranial Nerve VII,Marginal Mandibular Branch,Marginal Mandibular Nerve,Seventh Cranial Nerve,Nerve VII,Nerve of Wrisberg,Nervus Facialis,Nervus Intermedius,Nervus Intermedius of Wrisberg,Cranial Nerve VIIs,Cranial Nerve, Seventh,Facial Nerves,Mandibular Nerve, Marginal,Mandibular Nerves, Marginal,Marginal Mandibular Nerves,Nerve VIIs,Nerve, Facial,Nerve, Marginal Mandibular,Nerve, Seventh Cranial,Nerves, Marginal Mandibular,Nervus Faciali,Seventh Cranial Nerves,Wrisberg Nerve,Wrisberg Nervus Intermedius
D005155 Facial Nerve Diseases Diseases of the facial nerve or nuclei. Pontine disorders may affect the facial nuclei or nerve fascicle. The nerve may be involved intracranially, along its course through the petrous portion of the temporal bone, or along its extracranial course. Clinical manifestations include facial muscle weakness, loss of taste from the anterior tongue, hyperacusis, and decreased lacrimation. Acquired Facial Neuropathy,Cranial Nerve VII Diseases,Facial Myokymia,Facial Neuropathy,Geniculate Ganglionitis,Cranial Nerve VII Disorders,Facial Nerve Disorders,Facial Nerve Motor Disorders,Facial Nerve Sensory Disorders,Facial Neuritis,Familial Facial Neuropathy,Motor Disorders, Facial Nerve,Sensory Disorders, Facial Nerve,Seventh Cranial Nerve Diseases,Acquired Facial Neuropathies,Disease, Facial Nerve,Diseases, Facial Nerve,Disorder, Facial Nerve,Disorders, Facial Nerve,Facial Myokymias,Facial Nerve Disease,Facial Nerve Disorder,Facial Neuritides,Facial Neuropathies,Facial Neuropathies, Acquired,Facial Neuropathies, Familial,Facial Neuropathy, Acquired,Facial Neuropathy, Familial,Familial Facial Neuropathies,Ganglionitides, Geniculate,Ganglionitis, Geniculate,Geniculate Ganglionitides,Myokymia, Facial,Myokymias, Facial,Neuritides, Facial,Neuritis, Facial,Neuropathies, Facial,Neuropathies, Familial Facial,Neuropathy, Facial,Neuropathy, Familial Facial
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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