Revision Parotidectomy in Recurrent Salivary Pleomorphic Adenoma
Authors:
K. Obtulovičová 1; M. Sičák 1; M. Obtulovič 2; A. Kališ 3,4
Authors place of work:
Klinika otorinolaryngológie a chirurgie hlavy a krku, Ústredná vojenská nemocnica a fakultná nemocnica SNP v Ružomberku
prednosta, MUDr. M. Sičák, Ph. D.
1; Vysoká škola zdravotníctva a sociálnej práce sv. Alžbety v Bratislave
2; Fakulta zdravotníctva, Katolícka Univerzita Ružomberok
3; Ústav patologickej anatómie, Ústredná vojenská nemocnica a fakultná nemocnica SNP v Ružomberku
4
Published in the journal:
Otorinolaryngol Foniatr, 66, 2017, No. 2, pp. 60-65.
Category:
Original Article
Summary
Objectives:
Recurrent salivary pleomorphic adenoma is oncogenic continuance of primary tumor. Despite intraoperative capsule rupture, tumor cell spillage and histopathologic type, presumably the internal cell biology plays a role in the recurrence. Revision parotidectomy has high rate of facial nerve morbidity and does not exclude becoming recurrence. The aim of study was to evaluate the results of revisional surgery and to emphasize an importance of primary surgery.
Materials and Methods:
Eighteen patients who underwent 26 reoperations for recurrent parotid pleomorphic adenoma since 1989 to June 2016 were evaluated. The age of particular patients at the time of primary surgery ranged from 13 to 75 (mean 35) years. The female-to-male ratio made 7:2. In retrospective study we evaluated time interval between primary surgery and recurrence and surgical results including consecutive recurrence and facial nerve palsy.
Results:
In a group of 18 patients, the second recurrence was present in 7 cases, third in 4 cases and fourth in 1 case. The time interval between the primary and consecutive first, second, third and fourth recurrence was 1-24 (mean 8.0±7.1), 5-15 (8.3±3.1), 10-25 (11.5±2.1) and 27 years, respectively. Temporary facial nerve palsy was present in 11 cases (61%). Permanent facial nerve palsy (VI.degree of Brackmann-House classification) was present in one case (5.5%). The risk of second and consecutive recurrence was 39%.
Conclusion:
Recurrent pleomorphic adenoma is challenging problem. High risk of facial nerve injury in scar tissue is reduced in experienced hands using facial nerve monitoring. The risk of recurrence still exists even after long period after revisional surgery.
KEYWORDS:
recurrent pleomorphic adenoma, revision parotidectomy, facial nerve palsy, neuromonitoring
Zdroje
1. Bradley, P. J.: Recurrent salivary gland pleomorphic adenoma: ethiology, management and results. Curr. Opin. Otolaryngol. Head. Neck. Surg, 9, 2001, s. 100-108.
2. Brieger, J., Duesterfoeft, A., Brochhausen, Ch. et al.: Recurrence of pleomorfic adenoma of the parotid gland – predictive value of cadherin-11 and fascin. Jour. Comp, 116, 2008, s. 1050-1057.
3. Buchman, C., Stringe, S. P., Mendenhall, W. M. et al.: Pleomorphic adenoma: Effect of tumor spill and inadequate resection on tumor recurrence. Laryngoscope, 104, 1994, s. 1231-1234.
4. Bullerdiek, J., Takla, G., Bartnitzke, S.: Relationship of cytogenetic subtypes of salivary gland pleomorphic adenomas with patient age and histologic type. Cancer, 64, 1989, s. 876-880.
5. Carrew, J. F., Spiro, R. H., Singh, B. et al.: Treatment of recurrent pleomorphic adenomas of parotid gland. Otolaryngol. Head Neck Surg., 121, 1999, s. 539-542.
6. Donovan, D. T., Conley, J. J.: Capsular significance in parotid tumor surgery: Reality and myths of lateral lobectomy. Laryngoscope, 94, 1984, s. 324-329.
7. Dulguerov, P., Marchal, F., Lehmann, W.: Postparotidectomy facial nerve paralysis: possible ethiologic factors and results with routine facial nerve monitoring. Laryngoscope. 109, 1999, s. 754-762.
8. Fee, W. E., Goffinet, D. R., Calcaterra, T. C.: Reccurent mixed tumours of the parotid gland: results of surgical therapy. Laryngoscope, 88, 1978, s. 265-273.
9. Ghosh, S., Panarese, A., Bull, P. D. et al.: Marginally excised parotid pleomorphic salivary adenomas: risk factors for recurrence and management. A 12.5 year mean follow-up study of histologically marginal excisions. Clin. Otolaryngol. All. Sci, 28, 2003, s. 262-266.
10. Glas, A. S., Hollema, H., Nap, R. E. et al.: Expression of estrogen receptor, progesterone receptor, and Insulin-like growth factor receptor-1 and MIB-1 in patients with recurrent pleomorphic adenoma of the parotid gland. Cancer, 94, 2002, s. 2211-2216.
11. Goudot, P.: Pleomorphic adenoma of the salivary glands. Impact of the myxoid component on the prognosis. Rev. Stomatol. Chir. Maxillofac, 90, 1989, s. 119-122.
12. Hancock, B. D.: Pleomorphic adenomas of the parotid: removal without rupture. Ann. Roy. Coll. Surg. Eng, 69, 1987, s. 293-295.
13. Henriksson, G., Westrin, K. M., Carlsoo, B. et al.: Recurrent primary pleomorphic adenomas of salivary gland origin. Cancer, 82, 1998, s. 617-620.
14. Huawei, L., Weisheng, W., Haitao, H. et al.: Recurrent pleomorphic adenoma of the parotid gland. Intraoperative facial nerve monitoring during parotidectomy. Otolaryngol. Head Neck Surg., 151, 2014, s. 87-91.
15. Iro, H.: Benign protid tumors. Is it justified to move away from superficial and total parotidectomy as the standard of care for benign tumors? Salivary gland disease 1st international accord on modern management. July 4.-5. 2008, Paris, France.
16. Jackson, S. R., Roland, N. J., Clarke, R. W. et al.: Recurrent pleomorphic adenoma. J. Laryngol. Otol., 107, 1993, s. 546-549.
17. Laskawi, R., Schott, T., Schroder, M.: Recurrent pleomorphica adenomas of the parotid gland: clinical evaluation and long-term follow-up. Br. J. Oral. Maxillofac. Surg., 36, 1998, s. 48-51.
18. Maran, A. G. D., Mackenzie, I. J., Stanley, R. E.: Recurrent pleomorphic adenomas of the parotid gland. Arch. Otolar, 110, 1984, s. 167-171.
19. McGregor, A. D., Burgoyne, M., Tan, K. C.: Recurrent pleomorphic salivary adenoma – the relevance of age at first presentation. British Journal of Plastic Surgery, 41, 1988, s. 177-181.
20. Mehle, M. E., Kraus, D. H., Wood, B. G.: Facial nerve morbidity following parotid surgery for benign disease: The Cleveland clinic foundation experience. Laryngoscope, 103, 1993, s. 386-388.
21. Naeim, F., Forsberg, M. I., Waisman, J. et al.: Mixed tumors of salivary glands: growth pattern and reccurence. Arch. Pathol. Lab. Med., 100, 1976, s. 271-275.
22. Natvig, K., Soberg, R.: Relationship of intraopeartive rupture of pleomorphic adenomas to recurrence: an 11-25 year follow-up study. Head Neck, 16, 1994, s. 213-217.
23. Obtulovičová, K., Stárek, I., Salzman, R. et al.: Recurrent salivary pleomorphic adenoma shows increased immunohistologic expression of bcl-2 oncoprotein. Biomed. Pap. Med. Fac. Univ. Palacky Olomouc Czech Repub, 159, 2015,3, s. 460-465.
24. Olson, K. D., Daube, J. R.: Intraoperative monitoring of the facial nerve: an aid in the management of parotid gland recurrent pleomorphic adenomas. Laryngoscope, 104, 1994, s. 232-239.
25. Patey, D. H., Thackray, A. C.: The treatment of parotid tumours in the light of a pathological study of parotidectomy material. BJS, 45, 1958, s. 477-487.
26. Patrick, J., Bradley, M. B.: Recurrent salivary gland pleomorphic adenoma: ethiology, management and results. Current. Opinion. in Otolaryngol. and Head and Neck Surgery, 9, 2001, s. 100-108.
27. Renehan, A., Gleave, E. N., Hanckock, B. D.: Long-term follow-up of over 1000 patients with salivary tumours treated in a single centre. BJS, 83, 1996, s. 1750-1754.
28. Renehan, A., Gleave, E. N., McGurk, M.: An analysis of the treatment of 114 patientns with recurrent pleomorphic adenomas of the parotid gland. Am. J. Surg, 172, 1996, s. 710-714.
29. Samson, M. J., Metson, R., Wang, C. C.: Preservation of the facial nerve in management of recurrent pleomorphic adenoma. Laryngoscope, 101, 1991, s. 1060-1062.
30. Skálová, A., Walter, J., Stárek, I. et al.: Proliferační aktivita v pleomorfním adenomu: možnosti predikce recidiv. Čes. Stomat, 106, 2006, s. 27-32.
31. Stárek, I., Černý, L., Simpson, R. W. H.: Choroby slinných žláz. Grada Publishing, spol. s r.o., 2000.
32. Stennert, E., Guntinas-Lichius, O., Klussmann et al.: Histopathology of pleomorphic adenoma in the parotid gland: a prospective unselected series of 100 cases. Laryngoscope, 111, 2001, s. 2195-2200.
33. Webb, A. J., Evenson, J. W.: Pleomorphic adenomas of the major salivary glands: a study of the capsular form in relation to surgical management. Clin. Otolaryngol., 2001, 26, s. 134-142.
34. Witt, R. L., Eisele, D. W., Morton, R. P. et al.: Ethiology and management of recurrent parotid pleomorphic adenoma. Laryngoscope, 125, 2015, s. 888-593.
35. Wittekind, C., Streubel, K., Arnold, G. et al.: Recurrent pleomorphic adenoma of the parotid gland: analysis of 108 consecutive patients. Wiley InterScience [serial online] 2006 Dec [cited 2007 June 11]; 10: [22screens]. Dostupné z URL: http://www.interscience.wiley.com/DOI: 10.1002/hed.20613.
36. Zbären, P., Stauffer, E.: Pleomorphic adenoma of the parotid gland: Histopathologic analysis of the capsular characteristics of 218 tumors. Head Neck, 29, 2007, s. 751-757.
Štítky
Audiology Paediatric ENT ENT (Otorhinolaryngology)Článok vyšiel v časopise
Otorhinolaryngology and Phoniatrics
2017 Číslo 2
Najčítanejšie v tomto čísle
- Deep Neck Space Infections – Diagnostic and Therapy
- Occupational Noise-Induced Hearing Impairment – Part 1
-
Incidence of Complications in Operations on Thyroid Gland.
A Retrospective Analysis - CONE BEAM CT: použití mimo stomatologii