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Pleomorphic Adenoma of the Parotid Gland

Published:September 05, 2015DOI:https://doi.org/10.1016/j.amjmed.2015.08.014
      To the Editor:
      A 64-year-old man presented with a right-sided preauricular mass. It was painless but had gradually grown over several years (Figure A). Examination revealed a firm but mobile lump and normal facial nerve function. Fine-needle aspiration confirmed a pleomorphic adenoma. Magnetic resonance imaging showed the characteristic mixed composition of this benign salivary gland tumor (Figure B, asterisk and triangle). A superficial parotidectomy was performed and the patient's postoperative course was uneventful.
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      Figure(A) A 64-year-old patient with a right-sided preauricular mass. (B) Magnetic resonance image showing the characteristic mixed composition of the benign salivary gland tumor.
      Pleomorphic adenoma is the most common benign tumor of the salivary glands. When comparing tumors of different salivary glands, most parotid tumors are benign, whereas malignancy is more common in the submandibular, sublingual, and accessory salivary glands.
      • Guzzo M.
      • Locati L.D.
      • Prott F.J.
      • Gatta G.
      • McGurk M.
      • Licitra L.
      Major and minor salivary gland tumors.
      However, malignant transformation of pleomorphic adenomata can occur and is more likely to occur in larger tumors or those that have been present for many years. In addition, the risk of facial nerve injury is higher if the tumor is larger. Lastly, the postoperative recurrence rate is high if the tumor is incompletely removed. Therefore, surgical treatment should be early and removal complete.

      Reference

        • Guzzo M.
        • Locati L.D.
        • Prott F.J.
        • Gatta G.
        • McGurk M.
        • Licitra L.
        Major and minor salivary gland tumors.
        Crit Rev Oncol Hematol. 2010; 74: 134-148