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Recurrent Pleomorphic Adenoma of the Parotid Gland in Pediatric and Adult Patients: Value of Multiple Lesions as a Diagnostic Indicator

Korgün Koral1,2, James Sayre1, Sunita Bhuta3, Elliot Abemayor4 and Robert Lufkin1

1 Department of Radiological Sciences, Center for the Health Sciences, UCLA School of Medicine, 650 Charles E. Young Dr., S., Los Angeles, CA 90095.
2 Present address: Department of Radiology, University of Texas Southwestern Medical Center at Dallas and Children's Medical Center of Dallas, 1935 Motor St., Dallas, TX 75235.
3 Department of Surgical Pathology and Laboratory Medicine, Center for the Health Sciences, UCLA School of Medicine, Los Angeles, CA 90095.
4 Department of Surgery, Division of Head and Neck Surgery, Center for the Health Sciences, UCLA School of Medicine, Los Angeles, CA 90095.



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  		Fig. 1A. —39-year-old woman who underwent enucleation of left parotid gland mass 19 years previously and who presented with fullness in her throat. P = normal parotid gland on right. Unenhanced T1-weighted axial MR image shows multiple solid masses (arrows) in left parapharyngeal space causing narrowing of airway (arrowhead).

 


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  		Fig. 1B. —39-year-old woman who underwent enucleation of left parotid gland mass 19 years previously and who presented with fullness in her throat. P = normal parotid gland on right. T2-weighted MR image shows lesions (arrows) to be hyperintense. Arrowhead points to narrowed airway.

 


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  		Fig. 2. —41-year-old woman who underwent left superficial parotidectomy 15 years previously and who presented with nodules near left earlobe. Unenhanced T1-weighted axial MR image shows several round, low-intensity lesions (arrows) at parotidectomy bed. P = normal parotid gland on right.

 


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  		Fig. 3A. —Proposed mechanism for multiple lesions in recurrent pleomorphic adenomas of parotid gland. Drawing shows tumor as round mass with protrusions into surrounding tissue.

 


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  		Fig. 3B. —Proposed mechanism for multiple lesions in recurrent pleomorphic adenomas of parotid gland. Drawings show that as enucleation is performed (B), protrusions are left behind (C).

 


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  		Fig. 3C. —Proposed mechanism for multiple lesions in recurrent pleomorphic adenomas of parotid gland. Drawings show that as enucleation is performed (B), protrusions are left behind (C).

 


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  		Fig. 3D. —Proposed mechanism for multiple lesions in recurrent pleomorphic adenomas of parotid gland. Drawing shows that with time, these foci of tissue become larger and more confluent.

 

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