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Updated: Mar 1, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Why Do Parotid Pleomorphic Adenomas Recur? A Systematic Review of Pathological and Surgical Variables
Pavel Dulguerov1, Jelena Todic1, Marc Pusztaszeri2
1Department of Otorhinolaryngology - Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland.
Background:
The recurrence of pleomorphic adenoma (PA) has been extensively debated, mostly in relation to the extent of parotidectomy.
Methods:
A systematic review was undertaken to clarify the surgical and pathological variables related to PA recurrence. Inclusion criteria were as follows: English literature, and prospective or retrospective studies. Exclusion criteria were as follows: single case reports, reviews, and lack of PA recurrence data.
Results:
Pathology-related variables associated with recurrence include the histological subtype, the thickness and incompleteness of the tumor capsule, pseudopodia, and satellite nodules. Surgery-related variables associated with recurrence are the presence of intact margins and tumor puncture or spillage. Other factors are the size of the tumor and the age of patient. Myxoid subtypes of PA tend to have incomplete and thinner capsules and to recur more frequently. Surgical variables related to recurrence include positive margins and tumor spillage.
Conclusion:
Myxoid and/or large PA, especially in young patients, should be approached more cautiously to avoid recurrences.
