Pleomorphic adenoma without fascial nerve infiltration and Limited to superficial lobe treatment-
High-Yield Explanation
Ans. is 'a' i.e., Superficial parotidectory o Pleomorphic adenomas arise most commonly in the parotid gland. These form majority (~80-90%) of tumors of the parotid gland.o Pleomorphic adenomas are less common in the submandibular glands & sublingual glands; relatively rare in the minor glands.o Pleomorphic adenomas are benign tumors derived from a mixture of ductal (epithelial) and myoepithelial cells, and therefore show both epithelial and mesenchymal differentiation (hence k/a mixed tumor)o Although benign, it has the potential to turn malignant k/a carcinoma ex pleomorphic adenoma or malignant mixed tumor. The incidence of malignant transformation increases with the duration of the tumoro Signs & symptoms suspicious of malignant transformation# rapid growth# pain# paresthesias# facial weakness# skin invasion and fixation of mastoid tip.Treatment of Pleomorphic adenoma (or any benign lession of Salivary' gland)o in Parotid-superficial protidectomyo in other salivary glands-Excision of the affected gland.The above mentioned books mention the following indications of postop radiotherapy in Pleomorphic adenoma of parotid.Indications for postop radiotherapy in Pleomorphic adenomao Involvement of the deep lobe of the parotido Recurrent lesionso Large (> 5 cm) lesions, which may not allow complete surgical excision with adequate margins.o Microscopically positive margins after surgical resection.o Malignant transformation within a predominantly benign tumor.