A pleomorphic adenoma is a benign tumor in the salivary glands that appears as a firm and painless mass. In rare cases these tumors can sometimes become malignant (carcinoma ex pleomorphic adenoma) and will grow rapidly, cause pain and could become life-threatening. Treatment of the benign tumor is essential is preventing a malignant tumor from occurring.
Complete Surgical Excision
The most common and effective treatment for pleomorphic adenoma is a complete surgical excision of the tumor itself, according to the World Journal of Surgical Oncology (WJSO). The procedure involves the removal of the entire tumor and some surrounding tissue to prevent recurrence. A considerable amount of extra tissue may need to be removed, as these types of tumors are known to have finger-like extensions that grow into the area surrounding them.
A superficial parotidectomy is done under general anesthesia and takes approximately three to four hours to complete, according to Georgetown University Hospital. The surgeon makes an incision on the neck and near the ear. It typically heals with minimal scarring and without damaging the facial nerve.
The surgical risks involved in the removal of the tumor vary with the tumor itself. A smaller, more confined tumor will be easier to remove and therefore be less likely to cause damage to the facial nerve located nearby. A tumor that extends to a wider area may carry heavier risk. According to Georgetown University Hospital, surgeons are extremely careful in working near the facial nerve and most patients heal normally and do not experience any abnormal function.
Nerve weakness could occur for up to four months after surgery, but this generally does not require any therapy. Permanent nerve damage rarely occurs.
The possibility of infection exists with any surgical wounds, but can be treated with antibiotics. In addition, saliva may ooze from the incision after surgery. The surgeon should be notified, but usually this will only be temporary and should not require further treatment.
In some cases, doctors may feel that follow-up radiation treatment is necessary. The National Institutes of Health (NIH) do not recommend radiation therapy in all cases and suggest that it is reserved for specific patients with surgical difficulties. According to the NIH, radiation therapy could increase the likelihood that any recurring tumors become malignant. The WJSO reports that studies have shown a 6 to 7 percent recurrence rate for patients with benign pleomorphic adenoma.