This chapter discusses the etiology, clinical presentation, assessment, and treatment of recurrent pleomorphic adenoma. Recurrent tumor following surgery (or any other treatment) usually presents as a recurrent swelling at the primary site, with or without local symptoms. The incidence of recurrence following surgery varies depending on surgical technique, surgeon's experience, duration of follow-up, and clinical integrity. A recurrence rate of less than 1% is generally considered acceptable. The best policy to prevent recurrence of pleopmorphic adenoma is excisional biopsy of the tumor with maximal safe margin and functional neurological preservation. Treatment is determined by the age and physical health of the patient, number of pervious operations, and anatomical extent of the recurrence. Treatment options include observation, local excision, superficial parotidectomy, total conservative parotidectomy, total parotidectomy with resection of the involved nerve and immediate nerve graft (any procedure is followed by radiotherapy), and radiotherapy alone.
Current thinking about the management of recurrent pleomorphic adenoma of the parotid: a structured review