Pleomorphic adenoma natural history, complications and prognosis: Difference between revisions
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(/* Post-operative complications include{{cite journal|last1=Infante-Cossio|first1=P|last2=Gonzalez-Cardero|first2=E|last3=Garcia-Perla-Garcia|first3=A.|last4=Montes-Latorre|first4=E|last5=Gutierrez-Perez|first5=JL|last6=Prats-Golczer|first6=E|title=Com...) |
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{{Pleomorphic adenoma}} | {{Pleomorphic adenoma}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{M.N}} | ||
==Overview== | ==Overview== | ||
Pleomorphic adenoma is usually asymptomatic though some people present with a palpable nodular mass which is slow growing and painless. The complications that arise from surgery include rupture of the capsule of the tumor, incomplete resection of the tumor, [[haematoma]] or [[haemorrhage]], [[facial nerve palsy]], [[trismus]], wound infection, [[frey's syndrome]], parotid [[fistula]] and [[hypoesthesia]] of the [[greater auricular nerve]]. The prognosis of pleomorphic adenoma is generally excellent after complete resection of the tumor. Although a small proportion i.e 2-7% of cases can go to [[malignant]] transformation. | Pleomorphic adenoma is usually [[asymptomatic]] though some people present with a [[palpable]] [[nodular]] [[mass]] which is [[slow]] growing and painless. The [[complications]] that arise from [[Surgery operation|surgery]] include [[rupture]] of the [[capsule]] of the [[tumor]], incomplete [[resection]] of the [[tumor]], [[haematoma]] or [[haemorrhage]], [[facial nerve palsy]], [[trismus]], [[wound]] [[infection]], [[frey's syndrome]], [[parotid]] [[fistula]] and [[hypoesthesia]] of the [[greater auricular nerve]]. The [[prognosis]] of pleomorphic adenoma is generally excellent after complete [[resection]] of the [[tumor]]. Although a small [[Proportionality (mathematics)|proportion]] i.e 2-7% of cases can go to [[malignant]] [[transformation]]. | ||
==Natural History, Complications, and Prognosis== | ==Natural History, Complications, and Prognosis== | ||
===Natural History=== | ===Natural History=== | ||
*Pleomorphic adenoma usually presents as an asymptomatic disease. | *Pleomorphic adenoma usually presents as an [[asymptomatic]] [[disease]].<ref name="ZhanKhaja2016">{{cite journal|last1=Zhan|first1=Kevin Y.|last2=Khaja|first2=Sobia F.|last3=Flack|first3=Allen B.|last4=Day|first4=Terry A.|title=Benign Parotid Tumors|journal=Otolaryngologic Clinics of North America|volume=49|issue=2|year=2016|pages=327–342|issn=00306665|doi=10.1016/j.otc.2015.10.005}}</ref> | ||
*If symptomatic it presents as a slow growing, painless and a palpable single nodular mass. | *If [[symptomatic]] it presents as a [[slow]] growing, painless and a [[palpable]] single [[nodular]] [[mass]]. | ||
*If left untreated a small proportion of patients with | *If left untreated a small [[Proportionality (mathematics)|proportion]] of patients with peomorphic adenoma may progress to [[malignant]] [[transformation]]. | ||
===Complications=== | ===Complications=== | ||
====Intra-operative complications include:==== | ====Intra-operative complications include<ref name="Infante-CossioGonzalez-Cardero2018">{{cite journal|last1=Infante-Cossio|first1=P|last2=Gonzalez-Cardero|first2=E|last3=Garcia-Perla-Garcia|first3=A.|last4=Montes-Latorre|first4=E|last5=Gutierrez-Perez|first5=JL|last6=Prats-Golczer|first6=E|title=Complications after superficial parotidectomy for pleomorphic adenoma|journal=Medicina Oral Patología Oral y Cirugia Bucal|year=2018|pages=0–0|issn=16986946|doi=10.4317/medoral.22386}}</ref>:==== | ||
*Rupture of the capsule of the parotid tumor. | *[[Rupture]] of the [[capsule]] of the [[Parotid gland|parotid]] [[tumor]]. | ||
*Incomplete resection of the tumor. | *Incomplete [[resection]] of the [[tumor]]. | ||
*Facial nerve transection especially after [[superficial parotidectomy]] | *[[Facial nerve]] [[transection]] especially after [[Parotidectomy|superficial parotidectomy.]] | ||
*Haemorrhage or haematoma | ====Post-operative complications include<ref name="Infante-CossioGonzalez-Cardero2018">{{cite journal|last1=Infante-Cossio|first1=P|last2=Gonzalez-Cardero|first2=E|last3=Garcia-Perla-Garcia|first3=A.|last4=Montes-Latorre|first4=E|last5=Gutierrez-Perez|first5=JL|last6=Prats-Golczer|first6=E|title=Complications after superficial parotidectomy for pleomorphic adenoma|journal=Medicina Oral Patología Oral y Cirugia Bucal|year=2018|pages=0–0|issn=16986946|doi=10.4317/medoral.22386}}</ref>:==== | ||
*Infection at the site | *[[Haemorrhage]] or [[haematoma]] | ||
*[[Infection]] at the site | |||
*[[Trismus]] | *[[Trismus]] | ||
*Parotid fistula | *[[Parotid]] [[fistula]] | ||
*[[Frey's syndrome]]<ref name="pmid9373550">{{cite journal |vauthors=Bjerkhoel A, Trobbe O |title=Frey's syndrome: treatment with botulinum toxin |journal=J Laryngol Otol |volume=111 |issue=9 |pages=839–44 |date=September 1997 |pmid=9373550 |doi= |url=}}</ref> | *[[Frey's syndrome]]<ref name="pmid9373550">{{cite journal |vauthors=Bjerkhoel A, Trobbe O |title=Frey's syndrome: treatment with botulinum toxin |journal=J Laryngol Otol |volume=111 |issue=9 |pages=839–44 |date=September 1997 |pmid=9373550 |doi= |url=}}</ref> | ||
*[[Hypoesthesia]] of the [[greater auricular nerve]].<ref name="HuiWong2003">{{cite journal|last1=Hui|first1=Yau|last2=Wong|first2=David S.Y|last3=Wong|first3=Ling-Yuen|last4=Ho|first4=Wai-Kuen|last5=Wei|first5=William I|title=A prospective controlled double-blind trial of great auricular nerve preservation at parotidectomy|journal=The American Journal of Surgery|volume=185|issue=6|year=2003|pages=574–579|issn=00029610|doi=10.1016/S0002-9610(03)00068-0}}</ref> | *[[Hypoesthesia]] of the [[greater auricular nerve]].<ref name="HuiWong2003">{{cite journal|last1=Hui|first1=Yau|last2=Wong|first2=David S.Y|last3=Wong|first3=Ling-Yuen|last4=Ho|first4=Wai-Kuen|last5=Wei|first5=William I|title=A prospective controlled double-blind trial of great auricular nerve preservation at parotidectomy|journal=The American Journal of Surgery|volume=185|issue=6|year=2003|pages=574–579|issn=00029610|doi=10.1016/S0002-9610(03)00068-0}}</ref> | ||
Apart from the above mentioned other complications include facial disfigurement and multiple recurrences. | Apart from the above mentioned other [[complications]] include [[facial]] [[disfigurement]] and multiple recurrences. | ||
===Prognosis=== | ===Prognosis=== | ||
*Prognosis is generally excellent for most of the patients after surgical resection. | *[[Prognosis]] is generally excellent for most of the patients after surgical [[resection]]. | ||
*Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary sometimes. | *Depending on the extent of the [[tumor]] at the time of [[diagnosis]], the [[prognosis]] may vary sometimes. | ||
*Recurrence can be a problem if the tumor arises from the parotid gland.<ref name="pmid9578257">{{cite journal |vauthors=Laskawi R, Schott T, Schröder M |title=Recurrent pleomorphic adenomas of the parotid gland: clinical evaluation and long-term follow-up |journal=Br J Oral Maxillofac Surg |volume=36 |issue=1 |pages=48–51 |date=February 1998 |pmid=9578257 |doi= |url=}}</ref><ref name="WittekindtStreubel2007">{{cite journal|last1=Wittekindt|first1=Claus|last2=Streubel|first2=Kristina|last3=Arnold|first3=Georg|last4=Stennert|first4=Eberhard|last5=Guntinas-Lichius|first5=Orlando|title=Recurrent pleomorphic adenoma of the parotid gland: Analysis of 108 consecutive patients|journal=Head & Neck|volume=29|issue=9|year=2007|pages=822–828|issn=10433074|doi=10.1002/hed.20613}}</ref> | *Recurrence can be a problem if the [[tumor]] arises from the [[Parotid gland|parotid]] gland.<ref name="pmid9578257">{{cite journal |vauthors=Laskawi R, Schott T, Schröder M |title=Recurrent pleomorphic adenomas of the parotid gland: clinical evaluation and long-term follow-up |journal=Br J Oral Maxillofac Surg |volume=36 |issue=1 |pages=48–51 |date=February 1998 |pmid=9578257 |doi= |url=}}</ref><ref name="WittekindtStreubel2007">{{cite journal|last1=Wittekindt|first1=Claus|last2=Streubel|first2=Kristina|last3=Arnold|first3=Georg|last4=Stennert|first4=Eberhard|last5=Guntinas-Lichius|first5=Orlando|title=Recurrent pleomorphic adenoma of the parotid gland: Analysis of 108 consecutive patients|journal=Head & Neck|volume=29|issue=9|year=2007|pages=822–828|issn=10433074|doi=10.1002/hed.20613}}</ref> | ||
*2-7% of cases can go into malignant transformation if left untreated.<ref name="SaidCampana2005">{{cite journal|last1=Said|first1=Sherif|last2=Campana|first2=John|title=Myoepithelial carcinoma ex pleomorphic adenoma of salivary glands: A problematic diagnosis|journal=Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology|volume=99|issue=2|year=2005|pages=196–201|issn=10792104|doi=10.1016/j.tripleo.2003.11.014}}</ref> | *2-7% of cases can go into [[malignant]] [[transformation]] if left untreated.<ref name="SaidCampana2005">{{cite journal|last1=Said|first1=Sherif|last2=Campana|first2=John|title=Myoepithelial carcinoma ex pleomorphic adenoma of salivary glands: A problematic diagnosis|journal=Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology|volume=99|issue=2|year=2005|pages=196–201|issn=10792104|doi=10.1016/j.tripleo.2003.11.014}}</ref> | ||
==References== | ==References== | ||
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{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
[[Category: | |||
[[Category: Otolaryngology]] | |||
[[Category: Medicine]] | |||
[[Category: Oncology]] | |||
[[Category: Surgery]] | |||
[[Category: Up-To-Date]] | |||
Latest revision as of 19:42, 28 January 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maneesha Nandimandalam, M.B.B.S.[2]
Overview
Pleomorphic adenoma is usually asymptomatic though some people present with a palpable nodular mass which is slow growing and painless. The complications that arise from surgery include rupture of the capsule of the tumor, incomplete resection of the tumor, haematoma or haemorrhage, facial nerve palsy, trismus, wound infection, frey's syndrome, parotid fistula and hypoesthesia of the greater auricular nerve. The prognosis of pleomorphic adenoma is generally excellent after complete resection of the tumor. Although a small proportion i.e 2-7% of cases can go to malignant transformation.
Natural History, Complications, and Prognosis
Natural History
- Pleomorphic adenoma usually presents as an asymptomatic disease.[1]
- If symptomatic it presents as a slow growing, painless and a palpable single nodular mass.
- If left untreated a small proportion of patients with peomorphic adenoma may progress to malignant transformation.
Complications
Intra-operative complications include[2]:
- Rupture of the capsule of the parotid tumor.
- Incomplete resection of the tumor.
- Facial nerve transection especially after superficial parotidectomy.
Post-operative complications include[2]:
- Haemorrhage or haematoma
- Infection at the site
- Trismus
- Parotid fistula
- Frey's syndrome[3]
- Hypoesthesia of the greater auricular nerve.[4]
Apart from the above mentioned other complications include facial disfigurement and multiple recurrences.
Prognosis
- Prognosis is generally excellent for most of the patients after surgical resection.
- Depending on the extent of the tumor at the time of diagnosis, the prognosis may vary sometimes.
- Recurrence can be a problem if the tumor arises from the parotid gland.[5][6]
- 2-7% of cases can go into malignant transformation if left untreated.[7]
References
- ↑ Zhan, Kevin Y.; Khaja, Sobia F.; Flack, Allen B.; Day, Terry A. (2016). "Benign Parotid Tumors". Otolaryngologic Clinics of North America. 49 (2): 327–342. doi:10.1016/j.otc.2015.10.005. ISSN 0030-6665.
- ↑ 2.0 2.1 Infante-Cossio, P; Gonzalez-Cardero, E; Garcia-Perla-Garcia, A.; Montes-Latorre, E; Gutierrez-Perez, JL; Prats-Golczer, E (2018). "Complications after superficial parotidectomy for pleomorphic adenoma". Medicina Oral Patología Oral y Cirugia Bucal: 0–0. doi:10.4317/medoral.22386. ISSN 1698-6946.
- ↑ Bjerkhoel A, Trobbe O (September 1997). "Frey's syndrome: treatment with botulinum toxin". J Laryngol Otol. 111 (9): 839–44. PMID 9373550.
- ↑ Hui, Yau; Wong, David S.Y; Wong, Ling-Yuen; Ho, Wai-Kuen; Wei, William I (2003). "A prospective controlled double-blind trial of great auricular nerve preservation at parotidectomy". The American Journal of Surgery. 185 (6): 574–579. doi:10.1016/S0002-9610(03)00068-0. ISSN 0002-9610.
- ↑ Laskawi R, Schott T, Schröder M (February 1998). "Recurrent pleomorphic adenomas of the parotid gland: clinical evaluation and long-term follow-up". Br J Oral Maxillofac Surg. 36 (1): 48–51. PMID 9578257.
- ↑ Wittekindt, Claus; Streubel, Kristina; Arnold, Georg; Stennert, Eberhard; Guntinas-Lichius, Orlando (2007). "Recurrent pleomorphic adenoma of the parotid gland: Analysis of 108 consecutive patients". Head & Neck. 29 (9): 822–828. doi:10.1002/hed.20613. ISSN 1043-3074.
- ↑ Said, Sherif; Campana, John (2005). "Myoepithelial carcinoma ex pleomorphic adenoma of salivary glands: A problematic diagnosis". Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 99 (2): 196–201. doi:10.1016/j.tripleo.2003.11.014. ISSN 1079-2104.