Subtotal Parotidectomy for Pleomorphic Adenoma: A Case Report

Otto Aleman Miranda*, Yamila Dominguez Rodriguez, Yailen Solano Quinzan and Lianet Camila Menendez Martinez
Doctor of Stomatology, Specialist in oral and Maxillofacial surgery, Cuba
*Corresponding Author: Otto Aleman Miranda, Doctor of Stomatology, Specialist in oral and Maxillofacial surgery, Cuba.

Published: July 30, 2025

DOI: 10.55162/MCMS.09.306

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Abstract  

Pleomorphic adenoma (PA), or benign mixed tumor, is the most common neoplasm of the salivary glands, particularly affecting the parotid gland. It arises from epithelial and myoepithelial cells within a mesenchymal-like stroma and is typically characterized by slow, painless growth. Although benign, PA carries risks of recurrence and malignant transformation, especially in long-standing cases. Early diagnosis and complete surgical excision are key to effective management.

Case Presentation: We present the case of a 46-year-old male with no relevant medical history who reported a progressively enlarging, asymptomatic swelling in the right parotid region over several months. Physical examination revealed a firm, mobile, non-tender mass in the area of the parotid gland, with preserved facial nerve function. Diagnostic workup included high-resolution ultrasound and fine-needle aspiration biopsy (FNAB), both consistent with pleomorphic adenoma. Surgical treatment involved a subtotal parotidectomy of the superficial lobe via a modified Blair incision. Intraoperatively, the facial nerve and all its branches were carefully preserved. Histopathological analysis confirmed the diagnosis of pleomorphic adenoma with clear margins. The patient had an uneventful postoperative recovery, with no facial nerve deficits or wound complications. Follow-up evaluations at three and six months showed no evidence of recurrence.

Conclusion: This case highlights the classical presentation and optimal surgical management of pleomorphic adenoma of the parotid gland. Subtotal parotidectomy remains the treatment of choice for tumors confined to the superficial lobe, offering excellent oncologic control while minimizing functional and cosmetic morbidity. Thorough preoperative evaluation, skilled surgical technique, and long-term follow-up are essential to ensure successful outcomes and monitor for recurrence or malignant transformation.

Keywords: Pleomorphic adenoma; parotid gland tumor; benign salivary gland neoplasm; subtotal parotidectomy; facial nerve preservation; case report

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