Pleomorphic adenoma of the parotid gland in children

Summary Objective To evaluate the presentation, imaging characteristics and treatment outcome of pleomorphic adenoma of the parotid in the pediatric population. Design Retrospective study with institutional review board approval. Setting Tertiary care pediatric medical center. Methods An extensive review of medical records with regard to presentation, imaging, histopathology, complication, recurrence and prognosis on patients 18 years or younger presenting from 1983 to 2005. Results Eleven patients (six females, five males) were identified. The most common presentation was an asymptomatic mass. Preoperative imaging was done on nine patients: MRI ( N  = 6), CT ( N  = 3), ultrasound ( N  = 2), and sialogram ( N  = 1). Initial treatments included: superficial parotidectomy ( N  = 5), total parotidectomy ( N  = 3), excisional biopsy followed by superficial parotidectomy ( N  = 2), and excisional biopsy ( N  = 1). There were two recurrences (18%); one presenting 7 months following excisional biopsy who underwent superficial parotidectomy and one occurred 3 years following total parotidectomy requiring revision parotidectomy and radiation. Other complications included: transient facial nerve paresis ( N  = 5; 45%) and permanent weakness ( N  = 1; 9%). The patients were followed an average of 18 months. Conclusions Pleomorphic adenoma is one of the most common tumors of the parotid in children. The most common presentation is an asymptomatic mass. A preoperative evaluation with MRI or CT scan can be helpful in determining the extent of the lesion and surgical planning. Complete excision via superficial or total parotidectomy with preservation of facial nerve is the treatment of choice. Long-term follow up is recommended, though was difficult in a tertiary care center.