Experience of facial nerve management and postoperative radiotherapy in general recurrent pleomorphic adenoma of parotid gland: report of 10 consecutive cases

doi:10.19439/j.sjos.2021.06.021

Abstract

Abstract: PURPOSE: To preliminarily summarize the experience of facial nerve management and postoperative radiotherapy in general recurrent pleomorphic adenoma of parotid gland. METHODS: The clinical features of general recurrent pleomorphic adenoma of parotid gland were reviewed and analyzed, with emphasis on facial nerve management and postoperative radiotherapy. RESULTS: A total of 10 cases (6 males and 4 females) of general recurrent pleomorphic adenoma of parotid gland were collected. The age ranged from 23-51 years (mean: 38, median: 37). All patients suffered from multiple-recurred lesions. The initial management of 6 patients were removal of the tumor nodule under local anesthesia. Total parotidectomy plus facial nerve management based on specific situation (complete preservation in 5 cases, side-to-side anastomosis in 2 cases, great auricular nerve abridgement in 2 cases and masseter nerve transposition in 1 case) were performed. All the ten cases received adjuvant radiotherapy (dose: 55-62 Gy/25-30 Fx), and no tumor recurrence happened to date. CONCLUSIONS: The general recurrent pleomorphic adenoma of parotid gland may relapse repeatedly and invade widely. Surgery should be performed to remove the tumor thoroughly and protect the facial nerve as much as possible, and adjuvant radiotherapy may be beneficial to improve local control rate.

Key words: Recurrent pleomorphic adenoma, General recurrence, Parotid gland tumor, Facial nerve, Radiotherapy

CLC Number:

R739.8

XU Wan-lin, ZHU Yun, LU Hao, DING Ji-ping, YAO Yuan, LIU Sheng-wen, ZHANG Chen-ping, YANG Wen-jun. Experience of facial nerve management and postoperative radiotherapy in general recurrent pleomorphic adenoma of parotid gland: report of 10 consecutive cases[J]. Shanghai Journal of Stomatology, 2021, 30(6): 667-672.

References

[1] Tian Z, Li L, Wang L, et al.Salivary gland neoplasms in oral and maxillofacial regions: a 23-year retrospective study of 6982 cases in an eastern Chinese population[J]. Int J Oral Maxillofac Surg, 2010, 39(3): 235-242.
[2] Gao M, Hao Y, Huang MX, et al.Salivary gland tumours in a northern Chinese population: a 50-year retrospective study of 7190 cases[J]. Int J Oral Maxillofac Surg, 2017, 46(3): 343-349.
[3] 黄立勋, 翦新春. 腮腺复发性多形性腺瘤的临床分析—附22例报告[J]. 口腔医学研究, 2003, 19(1): 68-70.
[4] Bonavolonta P, Dell'Aversana Orabona G, Maglitto F, et al. Postoperative complications after removal of pleomorphic adenoma from the parotid gland: a long-term follow up of 297 patients from 2002 to 2016 and a review of publications[J]. Br J Oral Maxillofac Surg, 2019, 57(10): 998-1002.
[5] Barzan L, Pin M.Extra-capsular dissection in benign parotid tumors[J]. Oral Oncol, 2012, 48(10): 977-979.
[6] Werner RL, Castle JT.Recurrent pleomorphic adenoma[J]. Head Neck Pathol, 2014, 8(3): 303-306.
[7] Witt RL, Eisele DW, Morton RP, et al.Etiology and management of recurrent parotid pleomorphic adenoma[J]. Laryngoscope, 2015, 125(4): 888-893.
[8] 黄敏娴, 马大权, 俞光岩, 等. 复发性涎腺多形性腺瘤的临床与病理分析[J]. 现代口腔医学杂志, 2008, 22(1): 1-4.
[9] Kanatas A, Ho MWS, Mucke T.Current thinking about the management of recurrent pleomorphic adenoma of the parotid: a structured review[J]. Br J Oral Maxillofac Surg, 2018, 56(4): 243-248.
[10] 刘杰, 黄建涛, 姜蕾, 等. 腮腺复发性多形性腺瘤二次复发的多因素分析[J]. 中国口腔颌面外科杂志, 2010, 8(1): 79-84.
[11] 徐万林, 朱云, 卢浩, 等. 15例下颌下腺复发性多形性腺瘤临床病理分析[J]. 中国口腔颌面外科杂志, 2019, 17(5): 465-468.
[12] Shen S, Yang W, Wang Z, et al.Tumor-initiating cells are enriched in CD44(hi) population in murine salivary gland tumor[J]. PLoS One, 2011, 6(8): e23282.
[13] Shen S, Lu H, Liu L, et al.The role of CD44 in tumor-initiating cells of salivary gland pleomorphic adenoma: more than a surface biomarker[J]. Oral Dis, 2020, 26(3): 547-557.
[14] Wittekindt C, Streubel K, Arnold G, et al.Recurrent pleomorphic adenoma of the parotid gland: analysis of 108 consecutive patients[J]. Head Neck, 2007, 29(9): 822-828.
[15] 邓刚, 李晓光, 何悦, 等. 复发性腮腺多形性腺瘤的手术治疗及并发症预防[J]. 中国口腔颌面外科杂志, 2017, 15(3): 227-230.
[16] Zhu Y, Xu W, Zhang C, et al.Facial nerve preservation during giant mandibular tumor surgery[J]. J Craniofac Surg, 2017,28(2): e115-e117.
[17] Makeieff M, Venail F, Cartier C, et al.Continuous facial nerve monitoring during pleomorphic adenoma recurrence surgery[J]. Laryngoscope, 2005, 115(7): 1310-1314.
[18] Mc Loughlin L, Gillanders SL, Smith S, et al.The role of adjuvant radiotherapy in management of recurrent pleomorphic adenoma of the parotid gland: a systematic review[J]. Eur Arch Otorhinolaryngol, 2019, 276(2): 283-295.
[19] Chen AM, Garcia J, Bucci MK, et al.Recurrent pleomorphic adenoma of the parotid gland: long-term outcome of patients treated with radiation therapy[J]. Int J Radiat Oncol Biol Phys, 2006, 66(4): 1031-1035.
[20] Abu-Ghanem Y, Mizrachi A, Popovtzer A, et al.Recurrent pleomorphic adenoma of the parotid gland: Institutional experience and review of the literature[J]. J Surg Oncol, 2016, 114(6): 714-718.
[21] Leonetti JP, Marzo SJ, Petruzzelli GJ, et al.Recurrent pleomorphic adenoma of the parotid gland[J]. Otolaryngol Head Neck Surg, 2005, 133(3): 319-322.
[22] Zhu Y, Zhou S, Xu W, et al.Effects of postoperative radiotherapy on vascularized nerve graft for facial nerve repair in a rabbit model[J]. J Oral Maxillofac Surg, 2019, 77(11): 2339-2346.