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.

Sialometaplasia necrotizante: reporte de un caso y revisión de la literatura / Necrotizing sialometaplasia: case report and literature review

Introducción: La sialometaplasia necrotizante (SN) es una rara enfermedad benigna, inflamatoria de las glándulas salivales menores y mayores, comúnmente asociada a las ubicadas en la porción más posterior del paladar duro. La similitud de sus características clínicas e histológicas con algunas lesiones glandulares malignas, puede resultar en tratamientos innecesarios, considerando que la SN se resuelve espontáneamente entre 3-12 semanas. Caso clínico: Presentamos el caso de un adulto joven, con diagnóstico de SN, con sus características clínicas, histológicas y la evolución de la lesión.

Salivary glands Introduction: Necrotizing sialometaplasia (NS) is a rare benign inflammatory disease that affects the major and minor salivary glands. Commonly associated with the salivary glands of the rearmost portion of the hard palate. The similarity of their clinical and histological with some malignant glandular lesions may result in unnecessary treatment, whereas the NS resolves spontaneously within 3-12 weeks. Clinical case: We present the case of a young adult diagnosed with NS, with its clinical, histological and evolution of the injury.

Necrotizing sialometaplasia

Salivary glands

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 of palate: a case report

Necrotizing sialometaplasia (NS) which mimics malignancy both clinically and histopathologically is an uncommon benign, self-limiting inflammatory disease of the mucus-secreting minor salivary glands. The lesion is believed to be the result of vascular ischemia that may be initiated by trauma. Till date, the diagnosis of NS remains a challenge. This report demonstrates a case of NS in a 73-year-old male patient who presented with an ulcerative lesion in his palate. He had a history of local trauma and was long-term user of salbutamol inhaler. An incisional biopsy was carried out and the diagnosis was established through history, clinical examination, histopathology using Hematoxylin and Eosin stain. The patient was given symptomatic treatment and the lesion healed in about 7 weeks.

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.

Necrotizing sialometaplasia of parotid gland

A case of Necrotizing Sialometaplasia of parotid gland is reported. Clinical picture: This patient was initially diagnosed as a case of parotitis and treated by intravenous antibiotic for three days without improvement. Ultrasonography revealed fluid collection in the substance of the gland and needle aspiration revealed only blood. Fine needle aspiration was done and cytological examination revealed only blood cells without any glandular tissue. Incision and drainage of haematoma with incisional biopsy was done and histopathological examination confirmed the diagnosis of necrotizing sialometaplasia. After three weeks of conservative therapy without improvement superficial parotidectomy was done without any significant morbidity. Severe form of necrotizing sialoametaplasia affecting major salivary gland can be treated safely and effectively by sialoadenectomy

Necrotizing sialometaplasia: Report of 2 cases / 대한구강악안면방사선학회지

Necrotizing sialometaplasia (NS) was defined by Abrams et al. in 1973 as a reactive necrotizing inflammatory process involving minor salivary glands of the hard palate. Before that recognition, many patients with this condition had been improperly treated because of its clinical and histologic resemblance to malignancy such as mucoepidermoid carcinoma and squamous cell carcinoma. We report two cases of necrotizing sialometaplasia. One case involved a 58-year-old male who had an ulcerative palatal lesion exposing underlying bone which has the typical features of the above mentioned condition. Another case involved a 59-year-old male who developed a necrotizing sialometaplasia in association with a dome-shaped palatal swelling which was proved as an adenoid cystic carcinoma after operation biopsy.

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.

Trastornos de la conducta alimentaria: repercusiones a nivel oral / Feeding behavior disorders: oral repercussions

Con el propósito de describir las manifestaciones orales en pacientes con trastornos de la conducta alimentaria (TCA) se realizó un estudio prospectivo de observación de junio a septiembre de 1999, en el Servicio de Odontopediatría del Hospital Humberto Notti. Se examinaron 26 pacientes con trastornos alimentarios (25 mujeres, 1 varón). La frecuencia de TCA obtenida en nuestro estudio fue 35 por ciento anorexia, 46 por ciento bulimia y 19 por ciento mixto. El rango de edad osciló entre los 12 y 22 años (media 15 años). Se observó una alta incidencia de obturaciones desbordantes en pacientes bulímicas (p=0,02), como así también una alta incidencia de erosión dentaria en pacientes que provocaban el vómito (p=0,005). Motivó este trabajo la preocupación por una patología cuya incidencia ha aumentado en forma significativa en nuestro medio donde el odontólogo forma parte del equipo interdisciplinario de tratamiento y puede ser el primer profesional en detectar algún signo de sospecha en pacientes con posibles trastornos alimentarios

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.

Sialometaplasia necrosante: reporte de dos casos y revisión de la literatura / Necrotizing sialometaplasia: a report of two cases and review of literature

Se comunican dos casos de sialometaplasia necrosante de las glándulas salivales palatinas, la cual es una condición inflamatoria que clínica e histológicamente puede simular una neoplasia maligna. Se describen los hallazgos clínicos y microscópicos sobresalientes y se insiste en la necesidad de diferenciar este padecimiento de otras lesiones eritematovioláceas y ulcerativas que afectan a la mucosa palatina.

Necrotising adenometaplasia (sialometaplasia) of the nasopharynx.

Necrotising sialometaplasia of the nasopharynx with nasal extension in a 43 year old man, with no preceding history of trauma, is reported. Some unusual histological features are described.

Sialometaplasia necrotizante / Necrotizing syalometaplasia

Se presenta un caso de Sialometaplasia Necrotizante de fosa nasal que correspondería al cuarto caso publicado en la literatura revisada. Realizamos una descripción clínica e histopatológica de la enfermedad enfatizando el problema del diagnóstico diferencial con carcinoma mucoepidermoide y escamoso, haciendo hincapié en la resolución espontánea de este cuadro. Revisamos la literatura publicada hasta la fecha encontrando 8 publicaciones. Si bien es cierto que se propone una teoría de oclusión vascular como etiología del cuadro, la paciente no tenía ningún antecedente de patología o tratamientos previos, lo cual no excluye posibles lesiones asintomáticas anteriores al proceso de sialometaplasia. Creemos necesario tener presente el diagnóstico de Sialometaplasia Necrotizante en el caso de lesiones tumorales en fosa nasal ya que, a pesar de ser infrecuente, cambia notoriamente el pronóstico de sobrevida y la magnitud de tratamiento al paciente

Sialometaplasia necrotizante: apresentação de caso clínico / Necrotizing sialometaplasia: presentation of a clinical case

A sialometaplasia necrotizante é uma patologia pouco freqüente, (benigna) das glândulas salivares menores com características clínicas e histopatológicas que simulam o carcinoma epidermóide (10), ou o carcinoma mucoepidermóide (7, 10, 19, 28). Os autores descrevem um caso clínico e enfatizam a necessidade de um correto diagnóstico pois, no caso de confusão com um carcinoma, o paciente pode ser tratado com um procedimento cirúrgico agressivo e desnecessário

Sialometaplasia necrosante: relato de caso / Necrotizing sialometaplasia: case report

Os autores apresentam um caso de Sialometaplasia necrosante com manifestaçöes clínicas atípicas. Achados histopatológicos de biópsia e necrópsia säo apresentados. Revisando a literatura procuram mostrar a importância da lesäo como fonte de confusäo frente ao diagnóstico diferencial com o Carcinoma