What are the indications for adjuvant radiation for a resected intracapsular carcinoma ex pleomorphic adenoma of the parotid?

Do you approach similar to pleomorphic adenoma since it is still non-invasive? If there are indications for treating the primary, do you also electively treat the neck if there has been a neck dissection?

2 Answers

Mednet MemberInvited Expert

Radiation Oncology · University of Texas Medical Branch

Answered on

It is unclear to me how the "intracapsular" component would change management since I am not familiar with this entity. However, carcinoma ex pleomorphic adenoma is a high grade cancer and merits PORT.

If neck is pN0 after an adequate dissection, theoretically does not need treatment.

In treating a parotid bed, level 2 is usually mostly covered.

Pleomorphic adenoma is a benign tumor and can be managed surgically until it becomes a recurrent problem and further surgical salvage would risk com...

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Mednet Member

Radiation Oncology · Sutter Medcl Center

Answered on · Updated on

Any other thoughts on this question? This "intracapsular" WHO pathologic designation seems somewhat recent.

This review article states (emphasis mine, grammar per original authors): "The non-invasive CA-ex-PA is also known in the literature as intracapsular CA-ex-PA and carcinoma in situ. In this lesion, the carcinoma component is confined within the well-defined fibrous capsule of the PA. Non-invasive CA-ex-PA marks the early stages of the cellular malignant transformation and have resemble beh...

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