**Question:** Surgery of choice for pleomorphic adenoma is: September 2007, 2010

**Core Concept:** Pleomorphic adenoma is a benign tumor arising from the salivary gland, primarily affecting the parotid gland. The treatment of choice for pleomorphic adenoma depends on various factors such as tumor size, location, and recurrence risk.

**Why the Correct Answer is Right:**

The correct answer is **D.** Wide local excision (WLE) with a safety margin is the preferred surgical approach for pleomorphic adenoma. This type of surgery aims to remove the tumor and a small amount of surrounding healthy tissue to minimize the risk of tumor recurrence. WLE helps ensure complete removal of the tumor while preserving salivary gland function and minimizing potential complications like facial nerve damage or facial deformity.

**Why Each Wrong Option is Incorrect:**

A. **Radical neck dissection (RND)** is an aggressive surgical approach typically employed for advanced neck lymph node cancers or recurrent tumors. It is not appropriate for pleomorphic adenoma due to the risk of significant complications and unnecessary tissue removal.

B. **Resection of the masseter muscle** is a rare surgical approach that involves removing the masseter muscle along with the tumor. This option is not recommended as it would lead to significant facial muscle weakness and impaired masticatory function.

C. **Salivary gland preservation surgery** aims to preserve the salivary gland and its function. While this approach is beneficial in preserving function, it may increase the risk of tumor recurrence due to incomplete removal of the tumor.

**Clinical Pearl:** When managing pleomorphic adenoma, the goal of surgery is to achieve a balance between tumor removal and preserving salivary gland function and facial appearance. Wide local excision is the most suitable option among the choices provided as it reduces the risk of recurrence while minimizing complications.

**Correct Answer:** Wide local excision (D)