Key points
Recurrence after conservative resection of pleomorphic adenoma is a rare
and late phenomenon that poses a difficult management problem.
All recurrences at 6 years after capsular dissection were detected
clinically (recurrence rate 3.2%).
Magnetic resonance imaging failed to detect early occult recurrences
after conservative surgery and thus a “single shot” imaging modality
for follow up is not recommended.
Regular ultrasound and magnetic resonance imaging have been used after
surgery for early detection of a recurrence. The pickup rate is low so
the additional cost and effort of radiological surveillance is not
justified.
Follow up after parotid surgery for pleomorphic adenoma remains
clinical. There may be a benefit in regular surveillance imaging of high
risk patients (prior enucleation or resection after recurrence).