Polymorphous Low-Grade Adenocarcinoma: A Proposed Reconstruction Protocol Based on Past Surgical Experience

Area of Science:

• Oral and Maxillofacial Surgery
• Surgical Oncology
• Head and Neck Cancer

Background:

• Polymorphous low-grade adenocarcinoma (PLGA) is a rare salivary gland malignancy.
• Optimal surgical management and reconstruction protocols require further definition.
• Experience-based protocols can improve treatment outcomes for PLGA.

Purpose of the Study:

• To propose a reconstructive protocol for polymorphous low-grade adenocarcinoma (PLGA).
• To base the protocol on surgical management experience and primary lesion location.
• To guide reconstructive strategies for intraoral PLGA.

Main Methods:

• Retrospective analysis of 14 histologically confirmed PLGA patients.
• Evaluation of surgical management and reconstructive techniques used by a single surgeon.
• Data analysis focused on lesion characteristics and treatment outcomes.

Main Results:

• Mean follow-up was 6.2 years; mean age at diagnosis was 55.5 years.
• Intraoral non-painful lump was the most common presentation.
• Wide local excision was standard; reconstruction varied from primary closure to radial forearm graft. One recurrence and two patients requiring radiation therapy were noted.

Conclusions:

• Surgical management is the gold standard for PLGA treatment.
• Neck dissection is indicated only for confirmed lymph node involvement.
• Reconstruction strategies should be tailored to the primary lesion's location and size.