Carcinoma ex pleomorphic adenoma of the parotid gland. Study and implications for diagnostics and therapy

Background. Carcinoma ex pleomorphic adenoma (CXPA) is a rare parotid malignancy and until today no standardized concept exists for its therapy apart from recommendations for parotid carcinoma in general. Prognosis is thought to be poorer than for other parotid malignancies. We sought to describe a...

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Bibliographic Details
Published in:Acta oncologica 2009, Vol.48 (1), p.132-136
Main Authors: Lüers, Jan-Christoffer, Wittekindt, Claus, Streppel, M., Guntinas-Lichius, Orlando
Format: Article
Language:English
Subjects:
Adenoma, Pleomorphic - diagnosis
Adenoma, Pleomorphic - surgery
Adenoma, Pleomorphic - therapy
Adult
Aged
Aged, 80 and over
Carcinoma - diagnosis
Carcinoma - surgery
Carcinoma - therapy
Chemotherapy, Adjuvant
Female
Humans
Male
Middle Aged
Parotid Neoplasms - diagnosis
Parotid Neoplasms - surgery
Parotid Neoplasms - therapy
Radiotherapy, Adjuvant
Retrospective Studies
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Summary:Background. Carcinoma ex pleomorphic adenoma (CXPA) is a rare parotid malignancy and until today no standardized concept exists for its therapy apart from recommendations for parotid carcinoma in general. Prognosis is thought to be poorer than for other parotid malignancies. We sought to describe a general diagnostic and therapy strategy and assess factors predicting the outcome. Methods. We retrospectively analysed the courses of 22 patients with a CXPA of the parotid gland treated at a tertiary medical care centre for otorhinolaryngology. We examined parameters of medical history, diagnostics, surgical and adjunctive therapy and analysed overall and disease-specific survival. Results. About half of the patients had evidence of a parotid mass of up to 1 year only while maximum of the others was 48 years. Nine patients were primarily operated without suspicion for malignancy. Both 5-year disease-specific and overall survival were 60%. Recurrence-free survival rate after 5 years was 85%. Any patients with a stage I or II disease had an uneventful follow-up. To date, no patient with a stage IV disease has survived longer than 5 years. Conclusion. Surgical therapy (total or radical parotidectomy) is the method of choice for CXPA of the parotid gland. Stage I tumors have a very good and stage IV tumors a bad prognosis.
ISSN:0284-186X
1651-226X
DOI:10.1080/02841860802183604