Risk factors for carcinoma ex pleomorphic adenoma in patients presenting with recurrence after resection of pleomorphic adenoma

Linda X. Yin, Kathryn M. Van Abel, Steven A. Rooker, Alex A. Nagelschneider, Kerry D. Olsen, Daniel L. Price, Jeffrey R. Janus, Jan L. Kasperbauer, Eric J. Moore

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In patients presenting with recurrent pleomorphic adenoma (rPA), clinical evaluation can fail to recognize carcinoma ex PA (cxPA). We aim to identify the risk factors for cxPA. Methods: This is a single institution retrospective case-control study from 2000 to 2015. CxPA was diagnosed based on surgical pathology. Demographics, clinical, and social histories were collected. Results: A number of 13/106 (12.3%) patients were diagnosed with cxPA, of which only 4/13 (31%) had clinical features suspicious for malignancy. Compared to benign rPA, factors associated with cxPA included age >50 (odds ratio [OR] 6.67, 95% confidence interval [CI]: 1.71-25.98, P <.01), >10 pack-years of smoking history (OR 3.36, 95% CI: 1.01-11.14, P =.04), and the largest tumor being >2 cm on pathology (OR 4.42, 95% CI: 1.14-17.10, P =.03). Conclusions: In patients presenting with rPA, risk factors for malignant transformation include age >50, significant smoking history, and tumors larger than 2 cm. Clinical signs of malignancy such as rapid growth or pain are not always present.

Original languageEnglish (US)
Pages (from-to)419-427
Number of pages9
JournalHead and Neck
Volume43
Issue number2
DOIs
StatePublished - Feb 2021

Keywords

  • carcinoma ex pleomorphic adenoma
  • malignant transformation
  • pleomorphic adenoma
  • recurrent
  • salivary gland cancer

ASJC Scopus subject areas

  • Otorhinolaryngology

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