Can Magnetic Resonance Imaging detect subclinical recurrences after
capsular dissection of parotid pleomorphic adenomas?
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).