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Case Reports in Otolaryngology
Volume 2014 (2014), Article ID 914021, 3 pages
http://dx.doi.org/10.1155/2014/914021
Case Report

Massive Multinodular Head and Neck Recurrence of Parotid Gland Pleomorphic Adenoma: A Case Report

1Service d’ORL, Hôpital de la Croix-Rousse, 103 Grande rue de la Croix-Rousse, 69317 Lyon Cedex 4, France
2Service de Radiologie, Hôpital de la Croix-Rousse, 103 Grande rue de la Croix-Rousse, 69317 Lyon Cedex 4, France

Received 20 March 2014; Revised 18 May 2014; Accepted 1 June 2014; Published 22 June 2014

Academic Editor: Kai-Ping Chang

Copyright © 2014 Pierre Philouze et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. The optimal initial management of parotid pleomorphic adenomas reduces the risk of recurrence and malignant transformation. Surgery of recurrence can be difficult in multinodular disseminated forms. Case Report. A 67-years-old patient was referred for management of a large multifocal recurrence of a pleomorphic adenoma operated on 23 years ago. The clinical and radiological assessment found parapharyngeal, infratemporal, and prestyloid invasion, with nodules in the sternocleidomastoid muscle. Excision by transmandibular approach was performed. The pathologist found a multinodular recurrent pleomorphic adenoma without criteria of malignancy. Postoperative radiotherapy was performed. Discussion. Multinodular forms and incomplete resections are the most important factors that are thought to predispose to recurrence. A precise analysis of the extension by preoperative MRI is essential. Adjuvant radiotherapy can be given in these recurrent multifocal forms.