When compared to the population at large there was no excessive mortality beyond the first postoperative year. Two symptomatic recurrences were encountered 13 and 17 years following treatment. This emphasizes the need for late scans to detect slowly evolving recurrence. Following complete excision of an AN we recommend repeat enhanced MRI scanning at 1 and 5 years to screen for unanticipated recurrence. The 1 year study serves as a baseline to identify non-neoplastic enhancement due to scarring.
Cystic tumors are particularly likely to recur when merely debulked.
In both cases the cause was reformation of the capsule and progressive expansion of the cyst with little growth in the residual neoplastic component of the tumor. As a general rule, we strive to achieve total removal of AN whenever possible. Our policy is to avoid subtotal removal whenever possible, particularly when the tumor possesses a cystic component.