Leverstein H, Tiwari R M, Snow G B, van der Wal J E, van der Waal I
Department of Otolaryngology, Head and Neck Surgery, University Hospital Vrije, Universiteit, Amsterdam, The Netherlands.
Eur Arch Otorhinolaryngol. 1997;254(7):313-7. doi: 10.1007/BF02630721.
From 1974 to 1995, 40 patients were treated surgically at the University Hospital Vrije, Universiteit Amsterdam for recurrent or residual pleomorphic adenomas of the parotid gland after previous surgery. The median interval between the initial procedure and surgery for the recurrence was 122 months. Eleven patients had one or more attempts to resect tumor recurrences prior to referral. During reoperation at this institution it was decided to refrain from tumor resection in three patients. Tumor control in two of these patients was achieved using radiotherapy. In the third patient a "wait-and-see" policy was adopted. The other 37 patients underwent en bloc surgical excisions of their tumor and/or previously incised tissues. Among the 36 patients operated for histopathologically benign disease, 16 received postoperative radiotherapy (to 6500 cGy). None developed a further recurrence, the median follow-up being 106 months. Only one of these patients experienced permanent segmental facial nerve paralysis. Malignant transformation of tumor occurred in two patients. One of these patients died of locoregional disease after surgery and radiotherapy. Radical tumor resection was deferred in the other patient, with tumor control achieved using radiotherapy (7000 cGy). However, since recurrent disease tends to be multifocal in origin, prolonged routine follow-up is required.
1974年至1995年期间，阿姆斯特丹自由大学大学医院对40例曾接受过手术治疗的腮腺多形性腺瘤复发或残留患者进行了手术治疗。初次手术与复发手术之间的中位间隔时间为122个月。11例患者在转诊前曾有过一次或多次切除肿瘤复发灶的尝试。在该机构再次手术时，有3例患者决定不进行肿瘤切除。其中2例患者通过放疗实现了肿瘤控制。对第3例患者采取了“观察等待”策略。其他37例患者对其肿瘤和/或先前切开的组织进行了整块手术切除。在接受组织病理学诊断为良性疾病的36例手术患者中，16例接受了术后放疗（至6500 cGy）。均未出现进一步复发，中位随访时间为106个月。这些患者中只有1例出现永久性节段性面神经麻痹。2例患者发生了肿瘤恶变。其中1例患者在手术和放疗后死于局部疾病。另一例患者推迟了根治性肿瘤切除，通过放疗（7000 cGy）实现了肿瘤控制。然而，由于复发性疾病往往起源于多灶性，因此需要进行长期的常规随访。
