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Carcinoma ex pleomorphic adenoma (Ca ex PA) is an uncommon malignant tumor. It is an aggressive salivary carcinoma, arising from a primary or recurrent benign pleomorphic adenoma (PA). The most common clinical presentation of Ca ex PA is a firm mass in the parotid gland. Here we report a case of Ca ex PA, arising from a recurrent benign PA in the right parotid gland, in a 70-year old female patient. The lesion was first diagnosed as a PA and a superficial parotidectomy was performed. Re-operation was performed for recurrent PA. The second recurrence was diagnosed as Ca ex PA.