Pleomorphic adenoma natural history, complications and prognosis

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 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.

• Rupture of the capsule of the parotid tumor.
• Incomplete resection of the tumor.
• Facial nerve transection especially after superficial parotidectomy.

• 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 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]

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