Surgical treatment of recurrences of pleomorphic adenoma of the parotid gland.

From 1989 to 1999 a retrospective study was conducted on 7 patients with recurrent pleomorphic adenomas of the parotid gland who were referred to the MaxilloFacial Department of the University of Rome "La Sapienza" after having undergone surgery elsewhere. The mean time interval between the first operation and recurrences ranged from 15 months to 13 years, and the average time interval was 7.7 years. Implantability of the lesion and inadequate surgery that produced rupture of tumour capsule and tumour cells bleeding into surrounding glandular parenchyma, were the reasons for tumour recurrence. The instrumental examinations used for planning the surgical treatment to be applied and for studying the relations of recurrence with glandular parenchyma were CT (with contrast medium) or MR of head and neck. These patients underwent total parotidectomy with facial nerve preservation and no recurrence occurred in any patient. The results of this study underscore the importance of adequate surgical excision of initial recurrences as well as primary tumours to prevent tumour recidivism. Finally, tumour control rates and facial nerve preservation are enhanced with formal parotidectomy for recurrent tumour when feasible.