腮腺复发性多形性腺瘤的临床分析--附22例报告

目的：探讨腮腺多形性腺瘤复发、恶变的原因及临床治疗方法。方法：对22例腮腺多形性腺瘤复发患者进行回顾性分析和追踪调查。结果：多数腮腺多形性腺瘤复发病例肿块呈多灶性（18／22），手术越简单其复发率越高，复发间期越短（P＜0．05）。22人中有7例发生恶变，占31．8％，恶变与初发年龄较大有关（P＜0．05），与手术次数关系不大。末次手术分别采用浅叶切除术，腮腺全切术、扩大切除术，对7例有恶变者于术后辅以放射治疗。术后平均追踪54月，除1例多形性腺瘤恶变者于术后30月时肿瘤复发外，其余均未见复发。结论：不恰当的手术方式是导致腮腺性多形性腺瘤复发的直接原因。

Recurrent Pleomorphic Adenoma of the Parotid Gland:a Clinical Investigation of 22 Cases

Objective:To assess the clinical presentation and treatment results of recurrent pleomorphic adenoma of the parotid gland.Methods:The clinical references of 22 patients with recurrent pleomorphic adenoma of the parotid gland were analysed retrospectively.Results:Most cases of recurrent pleomorphic adenoma of the parotid gland presented multiple nodules.A limited initial excision was more likely to result in another recurrence and a shorter disease-free interval than a more aggressive surgical procedure.Malignance was occurred in 7 of 22 patients(31.8%).A comparison between the patients who underwent malignancy and those who didn't undergo malignancy showed that primary age of the disease was significantly older in the former( P <0.05).The eventual surgery was superficial parotidectomy in 3 patients,total parotidectomy in 11 patients and radical parotidectomy in 8 patients.Seven malignant patients received adjuvant postoperative irradiation.One malignant patient reoccurred in 30 months postoperatively.The others had no recurrence in a 54-month median follow-up period.Conclusions:Inadequate surgical excision of tumor was the main cause of the recurrence of the pleomorphic adenoma of the parotid gland.