NECROTIZING SIALOMETAPLASIA OF PALATE A RARE CASE REPORT

Necrotizing sialometaplasia (NS) is a rare benign reactive necrotizing in?ammatory process that affects the minor salivary gland and frequently mimics cancer on both a clinical and histopathological level. Case Study : We report the case of a 21-year-old healthy man who had throat pain and non-healing ulcer over soft palate for the past one month, with pain during swallowing.Histopathological analysis and an incisional biopsy were performed on the patient. Necrotizing sialometaplasia was the histologically determined diagnosis. Necrotizing sialometaplasia is a self-limiting disorder of salivary glands mostly affecting the hard palate.The duration of the healing process is usually related to the size of the lesion.The recurrence rate of Necrotizing Sialometaplasia is low.Even a full thickness palatal lesion heals completely within 6 months.

Non-ulcerated necrotizing sialometaplasia may mimic a salivary gland tumor

Necrotizing sialometaplasia (NS) is a benign, self-limiting inflammatory entity that mainly affects the minor salivary glands located in the hard palate. Classically, NS is characterized as a nodule that evolves to a central ulcer. The most widely recognized triggering factor is an ischemic event. The diagnosis becomes a challenge in non-ulcerated NS cases which is essential to rule out the possibility of salivary gland tumors, especially the malignant ones. Here, we presented a case of a 32-year-old male patient with a 1-month complaint of a painful, slightly elevated erythematous area on the hard palate. Incisional biopsy was performed, and NS was diagnosed based on histopathological and immunohistochemical analyses. Clinicians should be aware of and consider NS as a differential diagnosis of minor salivary gland tumors, particularly when it presents as a non-ulcerated clinical aspect.

Sialometaplasia Necrotizante: Revisión de la Literatura a Propósito de un Caso / Necroting Sialometaplasia: Review of the Literature on a Case

RESUMEN: La sialometaplasia necrotizante (SN) es una rara enfermedad benigna, inflamatoria, autolimitante, que afecta más frecuentemente a las glándulas salivales menores y que comúnmente se asocia a las ubicadas en la porción más posterior del paladar duro. Su etiología no esta clara, la mayoría de los autores sugieren que una lesión química, física o biológica de los vasos sanguíneos produciría cambios isquémicos, que provocarían infarto del tejido glandular con necrosis, inflamación e intento de reparación. Clínicamente puede presentarse como una úlcera de márgenes irregulares, ligeramente elevados y lecho necrótico, mientras que histopatológicamente se caracteriza por presentar metaplasia escamosa de conductos y acinos e hiperplasia pseudoepiteliomatosa del epitelio mucoso. La similitud de sus características clínicas e histopatológicas con algunas lesiones glandulares malignas de la cavidad oral, puede resultar en tratamientos innecesarios, considerando que la SN se trata de una patología autoresolutiva, por lo que es fundamental realizar un correcto diagnóstico clínico e histopatológico para evitar tratamientos quirúrgicos mutilantes o innecesarios. En el presente trabajo se presenta un caso de una mujer joven, con diagnóstico de SN, con sus características clínicas, histopatológicas y la evolución de la lesión.

ABSTRACT: The Necrotizing Sialometaplazia (NS) it's a rare self-limiting, inflammatory, benign disease, that most frequently affects the minor salivary glands and it is commonly associated to the glands located at the most posterior portion of the hard palate. Its etiology is not clear. Most authors suggest that a chemical, physical or biological lesion of the blood vessels would produce ischemic changes, which lead to infarction of muscle tissue with necrosis, inflammation and attempts to repair. Clinically it can present as a slightly elevated ulcer with irregular edges and necrotic bed, while histopathologically it is characterized for present squamous metaplasia of ducts and acini and pseudoepitheliomatous hyperplasia of mucosal epithelium. The similarity of its clinical and histopathological characteristics with some malignant glandular lesions of the oral cavity, can result in unnecessary treatments, considering that NS is a self-sustaining pathology, it is therefore essential to perform a correct clinical and histopathological diagnosis to avoid mutilating or unnecessary surgical treatments. In the present work we present the case of a young woman, with diagnosis of NS, with its clinical and histopathological characteristics and the evolution of the lesion.

Necrotizing sialometaplasia: Manifestation of a localized unclassified vasculitis.

Necrotizing sialometaplasia is a rare benign and self‑limiting disease, which commonly affects the minor salivary glands. Typically, it involves the seromucinous glands located at palate, buccal mucosa, tongue, tonsil, nasal cavity, trachea, larynx, maxillary sinus, and retromolar trigone. We report two such cases of necrotizing sialometaplasia to create awareness among the pathologists and surgeons because of its close morphological and clinical resemblance to squamous cell carcinoma. We have also documented that, the ischemic necrosis of salivary gland is the result of a vasculitic process.

Surgical management of necrotizing sialometaplasia of palate.

Necrotizing sialometaplasia (NSM) is a rare benign, inflammatory disease of both major and minor salivary glands, although more commonly reported in the minor glands of the palate. The characteristic clinical presentation can perplex the clinician and may be mistaken for a malignant neoplasm, such as mucoepidermoid carcinoma, as well as invasive squamous cell carcinoma. The clinical and histological similarity between this entity and a malignant lesion may result in unnecessary or mis-treatment. Though clinically mimics malignancy, NSM is considered to be a self-limiting disease, and takes about 3-12 weeks to resolve. Majority of the case resolves itself or by supportive and symptomatic treatment. Surgical intervention is rarely required in NSM except the diagnostic biopsy. Herein we report the clinical, histopathological feature and surgical management of a case of NSM of hard palate in a young adult male.

Contralateral recurrence of necrotizing sialometaplasia of the hard palate after five months: a case report

Necrotizing sialometaplasia usually heals within 4 to 10 weeks with conservative treatment, and rarely recurs. When necrotizing sialometaplasia is present on the hard palate it may occur unilaterally or bilaterally. In this case, necrotizing ulceration occurred on the left hard palate of a 36-year-old woman after root canal treatment of the upper left first premolar under local anesthesia. After only saline irrigation the defect of the lesion completely healed and filled with soft tissue. After 5 months, however, a similar focal necrosis was found on the contralateral hard palate without any dental treatment having been performed on that side and progressed in similar fashion as the former lesion. We conducted an incisional biopsy and obtained a final pathological diagnosis for the palatal mass of necrotizing sialometaplasia. At the 3-year follow-up, the patient's oral mucosa of the hard palate was normal, without any signs and symptoms of the condition. We report a case of a second occurrence of necrotizing sialometaplasia on the contralateral side from the first, with a time lapse between the first and second occurrence.

Necrotizing Sialometaplasia Accompanied by Adenoid Cystic Carcinoma on the Soft Palate

Necrotizing Sialometaplasia (NS) is a benign, self-limiting inflammatory disease of the mucus-secreting glands, and this illness mainly involves the minor salivary glands. The significance of NS resides in its clinical and histopathological resemblance to malignancy. We present here a case of necrotizing sialometaplasia on the soft palate, and this was accompanied by adenoid cystic carcinoma. We report here on this case to draw attention to the difficulty for deciding the extent of resecting a malignancy, and especially when the malignancy is simultaneously accompanied by necrotizing sialometaplasia.

A case of necrotizing sialomataplasia: consideration on cause, bone change, and incidence / 대한구강악안면방사선학회지

Necrotizing sialometaplasia (NS) is a rare, benign, self-limiting lesion, but it mimics carcinoma both clinically and histologically. Authors present a case of NS on the right posterior hard palate in a 16-year-old boy. This case showed underlying erosive bone change on CT images. We supposed this lesion resulted from the local anesthesia for dental treatment. Presented NS is the only one case from approximately 1, 500 oral and maxillofacial biopsies (0.07%) at Chonnam National University Hospital during the period from 1999 to 2004.

A Case of Necrotizing Sialometaplasia / 대한피부과학회지

Necrotizing sialometaplasia is a rare, benign, variably ulcerated, self-limiting disease of minor salivary glands. It may be frequently confused both clinically and histologically with squamous cell carcinoma or a minor salivary gland neoplasm. We present a case of necrotizing sialometaplasia on the inner surface of the lower lip developed in a 16-year-old man. To our knowledge, this is the first case repoit of necrotizing sialometaplasia in the Korean literature.