[Recurrent mixed parotid tumor localized in pharyngeal processus]

Area of Science:

• Otolaryngology
• Head and Neck Surgery
• Oncology

Background:

• Pleomorphic adenomas are the most common salivary gland tumors, typically benign.
• Parapharyngeal space tumors represent a small subset of parotid gland neoplasms.
• Malignization rates for pleomorphic adenomas range from 3.6% to 30%.

Observation:

• A 23-year-old patient presented with a history of five previous excisions of pleomorphic adenomas from the superficial parotid gland over 10 years.
• Despite multiple surgeries, a recurrent pleomorphic adenoma in the parapharyngeal space of the parotid gland was identified via advanced imaging (CT, MRI, angiography).
• The tumor continued to grow after surgical removal via a submandibular approach.

Findings:

• Post-operative radiation therapy was initiated for the recurrent parapharyngeal pleomorphic adenoma.
• A significant therapeutic response to radiation therapy was observed.
• The patient remained recurrence-free during an 8-month follow-up period.

Implications:

• This case highlights the potential for aggressive recurrence of pleomorphic adenomas, even after multiple surgical interventions.
• Radiation therapy may be a viable and effective treatment option for managing recurrent or persistent parapharyngeal pleomorphic adenomas.
• Multidisciplinary management, including surgical and oncological approaches, is crucial for optimizing outcomes in complex salivary gland tumor cases.