S Vergez1, N Fakhry2, C Cartier3, T Kennel3, M Courtade-Saidi4, E Uro-Coste4, A Varoquaux5, C-A Righini6, O Malard7, P Mogultay3, J Thariat8, S Tronche9, R Garrel3, D Chevalier10. 1. Service d'ORL et de chirurgie de la face et du cou, hôpital Larrey, institut universitaire du cancer de Toulouse Oncopole, CHU de Toulouse, Toulouse, France. Electronic address: vergez.s@chu-toulouse.fr. 2. Service d'ORL et chirurgie de la face et du cou, hôpital de la conception, AP-HM, Aix-Marseille Université, Marseille, France. 3. Service d'ORL et de chirurgie de la face et du cou, CHU de Montpellier, Montpellier, France. 4. Service d'anatomie et cytologie pathologiques, institut universitaire du cancer de Toulouse Oncopole, INSERM CRCT-Équipe 11, Toulouse, France. 5. Service de radiologie, hôpital de la conception, AP-HM, Marseille; AMU, Faculté de Médecine Timone CNRS-Centre for Magnetic Resonance in Biology and Medicine, Marseille, France. 6. Service d'ORL et de chirurgie de la face et du cou, CHU de Grenoble Alpes (CHUGA), Grenoble, France. 7. Service d'ORL et de chirurgie de la face et du cou, CHU Hôtel Dieu, Nantes, France. 8. Département de radiothérapie, centre François-Baclesse, Caen; Laboratoire de Physique Corpusculaire IN2P3/ENSICAEN-UMR6534-Unicaen-Normandie Université, Caen, France. 9. Société française d'ORL et chirurgie cervico-faciale, Strasbourg, France. 10. Service d'ORL et de chirurgie de la face et du cou, CHU de Lille, Lille, France.
Abstract
INTRODUCTION: The authors present the guidelines of the French Society of Otorhinolaryngology-Head and Neck Surgery (SFORL) for the diagnosis and treatment of pleomorphic adenoma (PA) of the salivary glands. METHOD: A review of the literature was performed by a multidisciplinary task force. Guidelines were drafted based on the articles retrieved and the workgroup members' individual experience. Guidelines were graded A, B, C or expert opinion by decreasing level of evidence. RESULTS: In clinically suspected salivary gland PA, MRI should be performed, including head and neck lymph node levels. Fine needle aspiration cytology is particularly recommended for tumours difficult to characterise by MRI. Frozen section biopsy should be performed to confirm diagnosis and adapt the surgical procedure in case of intraoperative findings of malignancy. Complete resection of the parotid PA should be performed en bloc, including margins, when feasible according to tumour location, while respecting the facial nerve. Enucleation (resection only in contact with the tumour) is not recommended. For the accessory salivary and submandibular glands, complete en bloc resection should be performed.
INTRODUCTION: The authors present the guidelines of the French Society of Otorhinolaryngology-Head and Neck Surgery (SFORL) for the diagnosis and treatment of pleomorphic adenoma (PA) of the salivary glands. METHOD: A review of the literature was performed by a multidisciplinary task force. Guidelines were drafted based on the articles retrieved and the workgroup members' individual experience. Guidelines were graded A, B, C or expert opinion by decreasing level of evidence. RESULTS: In clinically suspected salivary gland PA, MRI should be performed, including head and neck lymph node levels. Fine needle aspiration cytology is particularly recommended for tumours difficult to characterise by MRI. Frozen section biopsy should be performed to confirm diagnosis and adapt the surgical procedure in case of intraoperative findings of malignancy. Complete resection of the parotid PA should be performed en bloc, including margins, when feasible according to tumour location, while respecting the facial nerve. Enucleation (resection only in contact with the tumour) is not recommended. For the accessory salivary and submandibular glands, complete en bloc resection should be performed.