Salivary gland pleomorphic adenoma

Area of Science:

• Otolaryngology
• Surgical Oncology
• Head and Neck Surgery

Background:

• Pleomorphic adenoma is the most frequent benign salivary gland neoplasm, predominantly affecting middle-aged women.
• This slow-growing tumor, if left untreated, can lead to significant morbidity and, in rare instances, mortality.
• Most commonly found in the parotid gland, it necessitates timely and effective management.

Purpose of the Study:

• To review the current literature on the optimal treatment and outcomes for pleomorphic adenoma of the salivary glands.
• To elucidate the efficacy of surgical and radiotherapeutic interventions.
• To highlight the importance of facial nerve preservation during surgical procedures.

Main Methods:

• Comprehensive review of pertinent medical literature.
• Analysis of treatment strategies including parotidectomy and radiotherapy.
• Evaluation of reported outcomes, focusing on local control rates and complications.

Main Results:

• Superficial or total parotidectomy with facial nerve preservation offers local control rates exceeding 95%.
• Radiotherapy is effective for positive margins, unresectable tumors, and multifocal recurrences, with local control rates of 80-85% for microscopic and 40-60% for gross residual disease.
• Surgical resection is the primary treatment, yielding high cure rates, while radiotherapy complements surgery in specific challenging scenarios.

Conclusions:

• Surgical management, primarily parotidectomy, is the cornerstone for treating pleomorphic adenoma, ensuring high cure rates.
• Radiotherapy plays a crucial role in enhancing local control for patients with incompletely resected tumors or multifocal recurrences.
• Facial nerve injury is the primary complication associated with surgical treatment, underscoring the need for nerve preservation techniques.