Pleomorphic adenoma of the parotid in childhood Alberto Garcia-Perla, Macarena Mun˜ oz-Ramos, Pedro Infante-Cossio, Francisco Mayorga-Jimenez, Jose L. Gutierrez-Perez, Alvaro Garcia-Perla Department of Oral and Maxillofacial Surgery (Chairman: Prof. Alvaro Garcia-Perla), ‘Virgen del Rocio’ University Hospital, Seville, Spain SUMMARY. Introduction: Pleomorphic adenoma is a benign growth that most often appears in the parotid gland where it is the most frequent type of tumour. Its appearance in childhood is rare and there are no large series available in this age group for comparison with its presentation in adults. Surgical treatment is similar in children and in adults; whilst the prognosis is good, they may become malignant and metastasize. Material and Method: In this study, we present seven parotid pleomorphic adenomas in childhood treated in our Department and a review of the literature. The following data were evaluated: sex, age, affected side, clinical symptoms and period of evolution of the symptoms, surgical technique applied and complications observed. Results: The mean age at presentation was 12.4 years. All patients were males with the right side affected in five patients. The treatment was conservative superficial parotidectomy in five patients, conservative total parotidectomy in one, and an enucleation including a wide safety margin in the last case. None of the patients exhibited any permanent postoperative complication. The mean follow-up was 41.3 months (26–58 months). r 2002 European Association for Cranio-Maxillofacial Surgery Published by Elsevier Science Ltd. All rights reserved. INTRODUCTION Neoplasms originating in, or related to salivary glands are relatively uncommon in childhood, con- stituting less than 5% of the total number of salivary gland neoplasms with an incidence between 1.28 and 0.8% (Rogerson, 1995). Castro presented 30 cases of tumours in childhood in his review of a total of 2135 salivary gland tumours (Castro et al., 1972). The salivary tumour found most often in childhood is the pleomorphic adenoma apart from haemangioma and lymphangioma (being mesenchymal tumours) (Rogerson, 1995). All in all, pleomorphic adenoma is the most frequent tumour in salivary glands with a frequency between 54.1 and 65.6% (Renehan et al., 1996; Pinkston and Cole, 1999). It appears ten times more often in the parotid than in the submandibular gland, and is very rare in the sublingual gland. Some authors state that 65–75% of all parotid tumours are pleomorphic adenomas (Thackray and Lucas, 1974). MATERIAL AND METHOD One hundred and eight consecutive patients under- went surgery for a pleomorphic adenoma in the Department of Oral and Maxillofacial Surgery of ‘Virgen del Rocio’ University Hospital in Seville from 1995 to 1999. All cases less than 14 years of age at the time of diagnosis were included in this study. The following data were evaluated: sex, age, affected side, clinical symptoms and period of evolution of the symptoms. All other findings were reviewed and the diagnosis made by pre-surgical aspiration biopsy cytology was compared with the final histological diagnosis. The surgical technique used and the appearance of the following complications were also studied: immediately (bleeding, infection, fever, facial nerve paresis, flap necrosis), medium term (paresis, necrosis, salivary fistula), and long-term complica- tions (paresis, fistula, Frey’s syndrome, recurrence, facial deformity, unsightly scarring). RESULTS There were seven children who were diagnosed with parotid pleomorphic adenomas and treated surgically in our Department (Table 1). The mean age at presentation was 12.4 years (range 10–13 years). All patients were males, with the right side being affected in five (71%) and the left in two patients (29%). The tumour appeared always as a hard, painless growth in the parotid region, without lymphadenopathy or facial nerve involvement. The mean duration of symptoms before presentation was 7.9 months (1–12 months). In all cases ultrasound revealed a solid mass. Fine needle aspiration biopsy was suggestive of pleomorphic parotid adenoma in all cases. This was later confirmed by histological study of each of the surgically removed specimens. Treatment was surgical with a conservative superficial paroti- dectomy in five patients (71%), conservative total parotidectomy in one (14%) in whom the tumour had affected the deep lobe, and enucleation including 242 Journal of Cranio-Maxillofacial Surgery (2002) 30, 242–245 r 2002 European Association for Cranio-Maxillofacial Surgery. Published by Elsevier Science Ltd. All rights reserved. doi:10.1054/jcms.2002.0306, available online at http://www.idealibrary.com on