Consequences of Mismanagement in Malignant Parotid Tumors: A Report of Two Challenging Cases

Abstract

Malignant salivary gland tumors are a diverse group of neoplasms with unpredictable biological behavior and recurrence patterns, Recurrence rates of malignant parotid tumors vary across studies, influenced by differences in sample characteristics and follow-up protocols, Overall, reported rates range from 10% to 50%, however several factors contribute to recurrence malignant parotid gland tumors include tumor histology, initial surgical treatment, margin condition, perineural and lymph nodes involvement, we present a two cases of recurrent malignant parotid gland tumors, in which recurrence is likely due to incomplete initial resection of the tumor. The first case involved a 30-year-old male diagnosed with intermediate-grade mucoepidermoid carcinoma (stage III), who experienced recurrence five months post-surgery. The second case was a 55-year-old female with carcinoma ex pleomorphic adenoma (stage II), recurring two months after primary excision without adjuvant therapy. Both patients underwent revision surgery involving total parotidectomy, selective neck dissection (level IIa), and facial nerve preservation, followed by postoperative radiotherapy. These cases highlight the clinical and surgical challenges of recurrent malignant parotid tumors, emphasizing the need for accurate preoperative assessment, complete excision with adequate margins, and timely adjuvant therapy to improve disease control and patient outcomes.