From the Research
Pleomorphic adenoma of the salivary gland is a benign tumor that requires complete surgical excision, with superficial parotidectomy being the standard approach for parotid tumors to minimize the risk of recurrence and to avoid facial nerve injury, as supported by the study published in the American journal of clinical oncology 1.
Key Characteristics of Pleomorphic Adenoma
- Most common benign tumor of the salivary glands, accounting for about 60-70% of all salivary gland tumors
- Preferentially affects the parotid gland (about 80% of cases), but can also occur in the submandibular gland and minor salivary glands in the palate
- Typically presents as a slow-growing, painless, firm mass that develops over months to years
- Characterized by their mixed composition of epithelial and mesenchymal elements, which gives them their name "pleomorphic" meaning many forms
Treatment and Outcomes
- Treatment involves complete surgical excision, with superficial parotidectomy being the standard approach for parotid tumors
- Recurrence rate of 1-5% after proper excision, and approximately 5% have the potential for malignant transformation (carcinoma ex pleomorphic adenoma) if left untreated for many years, as reported in the study published in Anticancer research 2
- Regular follow-up is recommended after surgery to monitor for possible recurrence, especially in the first five years
- Radiotherapy (RT) may be useful in patients with positive margins, unresectable tumors, and multifocal recurrences after prior resection, as stated in the study published in the American journal of clinical oncology 1
Important Considerations
- The study published in Il Giornale di chirurgia 3 demonstrates that pericapsular enucleation is a viable alternative to superficial parotidectomy for the majority of parotid localizations, associated with reduced morbidity without oncological compromise
- The study published in Archives of craniofacial surgery 4 highlights the importance of complete surgical excision to minimize the risk of tumor recurrence, even in cases of repeated recurrences
- Malignant transformation of pleomorphic adenoma occurs in 5 to 25% untreated patients, usually after 15-20 years, and warning symptoms are present in the most cases, as reported in the study published in Otolaryngologia polska 5