KMID : 1195620090020040193
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Clinical and Experimental Otorhinolaryngology 2009 Volume.2 No. 4 p.193 ~ p.197
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Clinical Manifestations of Recurrent Parotid Pleomorphic Adenoma
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Suh Myung-Whan
Hah J-Hun Kwon Seong-Keun Jung Young-Ho Kwon Tack-Kyun Kim Kwang-Hyun Sung Myung-Whun
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Abstract
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Objectives: This study was undertaken to confirm the clinical characteristics of recurrent pleomorphic adenoma (RPA), and to identify those factors that affect the development of malignant transformation (MT) from RPA.
Methods: The medical records of 270 patients, who were operated upon for parotid PA, were retrospectively reviewed. The pathologic specimens of a selected series of 23 patients were reviewed for histologic subtype and microscopic multi-nodularity.
Results: Mean age of initial operation in RPA without MT (RPA-MT) group was significantly lower than that of primary PA group. Mean age of the revision operation in RPA with MT (RPA+MT) group was significantly greater than that of RPA-MT group. Mean interval from operation to recurrence shortened after each revision operation. The risk of MT and additional recurrence increased significantly with recurrence. In RPA-MT group tumor recurrence occurred in 21.4% of patients despite a clear resection margin.
Conclusion: The risk factors for MT may be an age of over 45 yr and multiple recurrences. However, younger patients are more at risk of recurrence. A clear resection margin cannot guarantee a cure in RPA, and it seems that parotid pleomorphic adenomas slowly gain malignant characteristics after repeated recurrences.
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KEYWORD
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Pleomorphic adenoma, Parotid glancl, Recurrence, Risk factor
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