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The recurrent pleomorphic adenoma conundrum.

Patrick J Bradley¹

¹Department Otorhinolaryngology, Head and Neck Surgery, Nottingham University Hospitals, Nottingham, UK.

Current Opinion in Otolaryngology & Head and Neck Surgery

|December 27, 2017

Summary

Recurrent pleomorphic adenoma (RPA) treatment involves surgery and/or radiotherapy. While surgery is preferred, RPA recurrence risk is linked to surgical factors. Radiotherapy shows promise for high-risk patients.

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Area of Science:

Head and Neck Surgery
Oncology
Tumor Recurrence

Background:

Recurrent pleomorphic adenoma (RPA) is an uncommon condition.
Treatment aims to minimize recurrence, functional/cosmetic sequelae, and malignant transformation.
Significant clinical advancements have occurred since 2001.

Purpose of the Study:

To comment on clinical progress in RPA management.
To discuss current patient treatment options for RPA.

Main Methods:

Review of recent literature on pleomorphic adenoma and RPA treatment.
Analysis of surgical approaches and radiotherapy efficacy.
Discussion of molecular pathology and biomarker research.

Main Results:

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Surgery is the primary treatment for head and neck pleomorphic adenoma.
Surgical radicality has evolved, with varied approaches for parotid and submandibular glands.
Molecular research has not differentiated RPA from primary tumors, suggesting surgery influences recurrence.
Radiotherapy is effective in controlling RPA in high-risk patients.

Conclusions:

Current surgical management offers improved quality of life with minimal sequelae.
RPA incidence is reduced with expert surgery, but follow-up is limited.
Combined surgery and/or radiotherapy is recommended for RPA patients.
Patient involvement in decision-making is encouraged.