Recurrent Parotid Pleomorphic Adenomas: Our Clinical Experience.

Objective The aim of our study was to present our findings in a series of patients who were treated for recurrent parotid pleomorphic adenoma with their clinical, surgical, and follow-up information and to discuss them in light of the recent literature. Methods Eleven patients who had revision surgery for recurrent pleomorphic adenoma at our institution were retrospectively analyzed for the clinical and radiological features of their lesions, surgery type, facial nerve management, and follow-up period. Results Seven patients were females and four were males with an average age of 45 years. All patients underwent previous surgeries at other institutions. Revision surgery was performed with superficial parotidectomy in six patients and total conservative parotidectomy with preservation of the facial nerve in five patients. Two patients had lesions involving the facial nerve branches necessitating sacrifice of involved branches. One patient was given adjuvant radiotherapy because of adjacent lymphatic vessel involvement with tumor cells. During the mean follow-up period of 9.1 years, there were no recurrences in any of the patients. Conclusion Management of patients with recurrent parotid pleomorphic adenomas must be carefully planned according to the size, location, and multicentricity of the tumor and involvement of the facial nerve. Surgery should aim at reaching tumor-free surgical margins. Sacrifice of the facial nerve should be considered only in cases with direct involvement. In the postoperative period, patients must be followed up regularly for early diagnosis of recurrences.