Recurrent Pleomorphic Adenoma

The treatment of choice for salivary gland neoplasms, both benign and malignant, is surgery with preservation of vascular and neurological structures. Recurrent pleomorphic adenoma following surgery (or any other treatment) usually presents as a recurrent swelling at the primary site, with or without local symptoms; a mass (unifocal) or multiple masses (multifocal), pain, ulcer, facial palsy, dyspnea, diplopia, or dysphonia, depending upon the primary site of origin. In general, a recurrence rate of <1% is considered acceptable. This chapter discusses the possible causes of recurrence of pleomorphic adenoma (pathology-related variables, surgery-related variables, and patient-related variables), the clinical course, evaluation (imaging and biopsy), and treatment options. It also addresses the importance of facial nerve preservation in recurrent cases and the risk of malignant transformation. Finally, this chapter also discusses the role of radiotherapy and its indications in the management of such recurrent cases.