Course and prognosis in recurrence of pleomorphic adenoma – A retrospective data analysis of a university hospital

Intro Clinical course of pleomorphic adenoma (PA) recurrence and treatment strategies have not been clearly studied due to the rarity of the disease and the long time course. The aim of our work was to retrospectively examine the clinical data of all patients who were treated with this diagnosis at the ENT university hospital cologne (UKK) for the course of the disease and therapy.

M&M From 06/1991 to 02/2021, 83 patients undergoing treatment for PA recurrence at UKK were identified. Characteristics of the patients, therapy as well as the course in the UKK (presentation frequency, imaging, surgery, facialis status and degeneration frequency) were retrospectively recorded and statistically analyzed.

Results 50 of 83 patients were female. 91% of the patients had received prior treatment; 61% more than once. The mean age at initial therapy was 32.2 years. In 66.7% preoperations were performed, 49% with a lateral parotidectomy. The interval between OP 1 and 2 was 6.9 years and decreased to 2.9 years (OP 5-6).

At UKK first presentation, the mean age was 45.7 years. Singular lesions were present in 51.5% and multiple ones in 45.9%. Surgery was performed in 61%. Here revision or total parotidectomy was the most common procedure. 46 of 83 patients presented again 148 times. Further surgery was performed in 35% (revision surgery in 92%). The interval between surgeries decreased from 4.3 (OP 1-2) to 1.7 years (OP 6-7). In 5 patients (9.8%) a malignancy (all adenocarcinoma) could be diagnosed during the course.

Conclusion PA recurrences affected young patients and accompanied the affected individuals over a long period. The probability of repeated surgery was 35%. The time intervals between revisions decreased significantly. The incidence of malignancy in these patients was 9.8%.

Publication History

Article published online:
24 May 2022