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Prognostic factors for secondary recurrence of pleomorphic adenoma: a 20-year, retrospective study

  • O Malard (a1), R Wagner (a1), M Joubert (a2), A-S Delemazure (a3), E Rio (a4), N Durand (a1) and F Espitalier (a1)...



To evaluate the results of treatment of parotid pleomorphic adenoma, and the risk factors for secondary recurrence.

Materials and methods:

Single-centre, retrospective study of 32 patients with pleomorphic adenoma recurrence managed between 1988 and 2008.


The mean age at diagnosis of primary pleomorphic adenoma recurrence was 43.4 years. Twenty-eight per cent of patients had secondary recurrence; 32 per cent had undergone two or more surgical resections and external adjuvant radiotherapy. An age of less than 25 years was significantly associated with an earlier primary recurrence (p = 0.008). The most significant histopathological risk factor for secondary recurrence was the presence of a multifocal tumour (p = 0.019). Other histopathological criteria (i.e. cellularity and capsule rupture) were not significant. Radiotherapy was not associated with a decrease in recurrence. Nine per cent of patients progressed to malignancy. The main surgical complication was definitive facial palsy (14 per cent).


Pleomorphic adenoma recurrence requires surgery, with greatly increased risk to the facial nerve. Resection with clear surgical margins is required, especially in young patients with multifocal tumours. Radiotherapy may delay second recurrence in cases of multifocal tumour.


Corresponding author

Address for correspondence: Professor Olivier Malard, Service d'ORL et de chirurgie cervico-faciale, CHU Hôtel Dieu, 1 Place A Ricordeau, BP 1005, 44093 Nantes, Cedex 01, France Fax: +33 2 40 08 34 77 E-mail:


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1Chen, CP, Wang, SJ, van Zante, A, Yom, SS. Stepwise regional and distant progression of recurrent pleomorphic adenoma. J Otolaryngol Head Neck Surg 2011;40:510
2Wittekindt, C, Streubel, K, Arnold, G, Stennert, E, Guntinas-Lichius, O. Recurrent pleomorphic adenoma of the parotid gland: analysis of 108 consecutive patients. Head Neck 2007;29:822–8
3Seifert, G, Brocheriou, C, Cardesa, A, Eveson, JW. WHO international histological classification of tumours. Tentative histological classification of salivary gland tumours. Pathol Res Pract 1990;186:555–81
4Leonetti, JP, Marzo, SJ, Petruzzelli, GJ, Herr, B. Recurrent pleomorphic adenoma of the parotid gland. Otolaryngol Head Neck Surg 2005;133:319–22
5Redaelli de Zinis, LO, Piccioni, M, Antonelli, AR, Nicolai, P.Management and prognostic factors of recurrent pleomorphic adenoma of the parotid gland: personal experience and review of the literature. Eur Arch Otorhinolaryngol 2008;265:447–52
6Phillips, PP, Olsen, KD. Recurrent pleomorphic adenoma of the parotid gland: report of 126 cases and a review of the literature. Ann Otol Rhinol Laryngol 1995;104:100–4
7Renehan, A, Gleave, EN, McGurk, M. An analysis of the treatment of 114 patients with recurrent pleomorphic adenomas of the parotid gland. Am J Surg 1996;172:710–14
8Laskawi, R, Schott, T, Schroder, M. Recurrent pleomorphic adenomas of the parotid gland: clinical evaluation and long-term follow-up. Br J Oral Maxillofac Surg 1998;36:4851
9Chilla, R. Treatment of recurrent pleomorphic adenoma [in German]. HNO 1997;45:955–6
10McGurk, M. Recurrent mixed tumors of the major and minor salivary glands. In: Norman, JEdB, McGurk, M, eds. Colour Atlas and Text of the Salivary Glands: Disease, Disorders and Surgery. London: Mosby-Wolfe, 1995;202–21
11Glas, AS, Hollema, H, Nap, RE, Plukker, JT. Expression of estrogen receptor, progesterone receptor, and insulin-like growth factor receptor-1 and of MIB-1 in patients with recurrent pleomorphic adenoma of the parotid gland. Cancer 2002;94:2211–16
12Zbaren, P, Tschumi, I, Nuyens, M, Stauffer, E. Recurrent pleomorphic adenoma of the parotid gland. Am J Surg 2005;189:203–7
13Lam, KH, Wei, WI, Ho, HC, Ho, CM. Whole organ sectioning of mixed parotid tumors. Am J Surg 1990;160:377–81
14Rodriguez, KH, Vargas, S, Robson, C, Perez-Atayde, A, Shamberger, R, McGill, TJ et al. Pleomorphic adenoma of the parotid gland in children. Int J Pediatr Otorhinolaryngol 2007;71:1717–23
15Stennert, E, Wittekindt, C, Klussmann, JP, Arnold, G, Guntinas-Lichius, O. Recurrent pleomorphic adenoma of the parotid gland: a prospective histopathological and immunohistochemical study. Laryngoscope 2004;114:158–63
16Carew, JF, Spiro, RH, Singh, B, Shah, JP. Treatment of recurrent pleomorphic adenomas of the parotid gland. Otolaryngol Head Neck Surg 1999;121:539–42
17Malard, O, Toquet, C, Gayet-Delacroix, M, Bordure, P, Beauvillain de Montreuil, C, Bardet, E. Radiation-induced cancers of the pharynx and larynx: a study of five clinical cases. Clin Otolaryngol Allied Sci 2002;27:6874
18Niparko, JK, Beauchamp, ML, Krause, CJ, Baker, SR, Work, WP. Surgical treatment of recurrent pleomorphic adenoma of the parotid gland. Arch Otolaryngol Head Neck Surg 1986;112:1180–4
19Myssiorek, D. Removal of the inferior half of the superficial lobe is sufficient to treat pleomorphic adenoma in the tail of the parotid gland. Arch Otolaryngol Head Neck Surg 1999;125:1164–5
20Lowry, TR, Gal, TJ, Brennan, JA. Patterns of use of facial nerve monitoring during parotid gland surgery. Otolaryngol Head Neck Surg 2005;133:313–18



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