Benign Mixed Tumors of the Head and Neck: Chondroid Syringoma and Metastasizing Pleomorphic Adenoma

The patient is a 28-year-old man who presented with a 13year history of multiply recurrent pleomorphic adenoma of the right parotid gland. He had undergone two surgical resections at outside hospitals when he presented in 2006 with several palpable masses within the right parotid bed. A contrastenhanced MRI revealed a multifocal recurrence in the superficial lobe of the parotid and the patient underwent revision parotidectomy. During the surgery five separate foci of tumor were identified within the superficial lobe of the gland. A capsule of normal parotid tissue was left around the specimen and it was excised en bloc with preservation of the underlying facial nerve branches. During the postoperative period the patient had normal facial nerve function and healed without complications. Because of his history of multiple recurrences, the patient was referred for adjuvant radiation therapy. A course to the right parotid bed was abbreviated to 2000 cGy due to patient noncompliance. One year later he returned with 2 small well circumscribed nodules at the central forehead and right parietal scalp. FNA cytology was read as benign skin adnexal lesions, consistent with chondroid syringomas. The patient underwent simple excision of the lesions, which were both subcutaneous, well encapsulated and less than 1 cm in diameter. The final pathology was read as benign mixed tumors, consistent with chondroid syringomas or benign metastasizing pleomorphic adenomas. A contrast-enhanced MRI performed 5 months later showed no evidence of recurrence in the head and neck. Benign Mixed Tumors of the Head and Neck: Chondroid Syringoma and Metastasizing Pleomorphic Adenoma Gregg H. Goldstein, M.D., Benjamin D. Malkin, M.D., Michael Rivera, M.D., Eric M. Genden, M.D. Mount Sinai School of Medicine, Department of Otolaryngology—Head and Neck Surgery, New York, NY