{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T16:01:39Z","timestamp":1779206499304,"version":"3.51.4"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,10,12]],"date-time":"2020-10-12T00:00:00Z","timestamp":1602460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In patients presenting with recurrent pleomorphic adenoma (rPA), clinical evaluation can fail to recognize carcinoma ex PA (cxPA). We aim to identify the risk factors for cxPA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a single institution retrospective case\u2010control study from 2000 to 2015. CxPA was diagnosed based on surgical pathology. Demographics, clinical, and social histories were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A number of 13\/106 (12.3%) patients were diagnosed with cxPA, of which only 4\/13 (31%) had clinical features suspicious for malignancy. Compared to benign rPA, factors associated with cxPA included age &gt;50 (odds ratio [OR] 6.67, 95% confidence interval [CI]: 1.71\u201025.98, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01), &gt;10 pack\u2010years of smoking history (OR 3.36, 95% CI: 1.01\u201011.14, <jats:italic>P<\/jats:italic> = .04), and the largest tumor being &gt;2\u2009cm on pathology (OR 4.42, 95% CI: 1.14\u201017.10, <jats:italic>P<\/jats:italic> = .03).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients presenting with rPA, risk factors for malignant transformation include age &gt;50, significant smoking history, and tumors larger than 2\u2009cm. Clinical signs of malignancy such as rapid growth or pain are not always present.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.26489","type":"journal-article","created":{"date-parts":[[2020,10,12]],"date-time":"2020-10-12T08:24:22Z","timestamp":1602491062000},"page":"419-427","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Risk factors for carcinoma ex pleomorphic adenoma in patients presenting with recurrence after resection of pleomorphic adenoma"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8515-2051","authenticated-orcid":false,"given":"Linda X.","family":"Yin","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0513-4203","authenticated-orcid":false,"given":"Kathryn M.","family":"Van Abel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5442-8702","authenticated-orcid":false,"given":"Steven A.","family":"Rooker","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex A.","family":"Nagelschneider","sequence":"additional","affiliation":[{"name":"Department of Radiology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerry D.","family":"Olsen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel 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