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Necrotizing sialometaplasia can make anyone very anxious about the lesion especially if they have habit of tobacco consumption. It requires a prompt diagnosis, counseling with assurance to patient and treatment.

Introduction: Necrotizing sialometaplasia (NS) is a rare locally destructive inflammatory benign disease that commonly affects the minor salivary glands. It is frequently associated with the glands located in the posterior portion of the hard and soft palates. Low-level laser therapy (LLLT), also called photobiomodulation therapy (PBMT), has been deemed a substantial method for the regenerative wound process. Case Presentation: A 32-year-old male patient was referred with a chief complaint of two asymptomatic crater-like ulcers measuring approximately 1.5 cm wide on the right side of the hard and soft palates, and another measuring 0.3 cm wide on the left side of the hard palate. The lesion had two weeks of evolution followed by a previous infectious "sore throat" event that kept the patient hospitalized for 4 days. A clinical diagnosis of NS was made. LLLT was applied during 2 sessions per week, favoring the total wound healing within 2 weeks. At 3 months of clinical followup, the patient did not present any complication or relapse and was thus released. Conclusion: This is, to our knowledge, the first clinical report of LLLT applied for the management of NS. Large palatal ulcers caused by NS usually have long healing periods. The shortened healing period observed in this case encourages the inclusion of LLLT in any treatment protocol for similar lesions.

Introduction Necrotizing sialometaplasia (NSM) is a benign, self-limiting, inflammatory disease of salivary glands, mainly involving the minor salivary glands in the palate. This lesion can mimic a malignant neoplasm, both clinically and histopathologically, manifesting as a submucosal swelling or as an ulcer of the palate. We illustrate our work with a case of necrotizing sialometaplasia misdiagnosed as carcinoma. Case presentation A 26 years old woman presented to dental treatment and consultation center of Rabat, for a rehabilitation of left palatal bone defect with an obturator prothesis. A postsurgical erythematous area was noted at the left palate during intraoral examination. After medical file study, we founded that she had a necrotizing sialometaplasia treated by maxillectomy of the left maxillary bone, and we realized that a diagnostic error was made leading to an aggressive treatment. Clinical discussion Necrotizing sialometaplasia can be misdiagnosed clinically and microscopically as a malignant neoplasm, resulting in inappropriate and aggressive treatment like the case presented. Conclusion The diagnosis of NSM is challenging, the role of histopathology and immunohistochemistry is of paramount importance., Highlights • Necrotizing sialometaplasia (NSM) is a benign, self-limiting, inflammatory disease of salivary glands. • The diagnosis of NSM is challenging, it can mimic a malignant neoplasm. • The role of histopathological test and immunohistochemistry is of paramount importance.

Necrotizing sialometaplasia (NSM) is a benign, reactive metaplastic condition of the minor salivary gland tissue typically seen in the setting of injury, chemical or traumatic, and is nonneoplastic and self-limited. The diagnosis may be challenging as it may clinically mimic malignancy. We present the case of a 74-year-old male with a 1 pack per day smoking history for 60 years who presented with a reported 20-pound weight loss, dysphagia, and dysphonia progressing over the course of 6 months and found to have a 3.5-cm hypopharyngeal mass on computed tomography imaging and fiberoptic laryngoscopy. Initial frozen section of the mass was concerning for squamous cell carcinoma in situ, but permanent specimens returned as nondiagnostic. Repeat biopsy established a diagnosis of NSM. Two-month follow-up showed complete resolution of the mass. Clinicians should be aware that NSM may present in unusual locations when considering differential diagnoses for laryngeal masses and evaluating for malignancy.

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.

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.

Necrotizing Sialometaplasia (NS) is a rare, benign, self-limited, inflammatory and necrotizing reaction of the salivary glandular tissue. Due to the clinical picture (a painful ulcer with well-defined edges), and histopathological characteristics (nuclear and cellular pleomorphism of ductal cells) NS can mimic a malignant lesion. The correct diagnosis is important because NS shows a spontaneous resolution and therefore no further treatment is needed. We report a very unusual case of spontaneous and recurrent NS located on the anterior tonsillar pillar in a 43-year old man, which clinically mimics a malignant lesion. The clinician should be aware to include NS in the differential diagnosis of ulcers in soft palate and tonsillar pillars. Key words:Minor salivary gland, necrotizing sialometaplasia, oral ulcer, squamous cell carcinoma, tonsillar pillar.

Necrotizing Sialometaplasia is rare and in the oral cavity it accounts

Necrotizing sialometaplasia is a salivary gland disease which is clinically as well as histologically quite confusing with a malignant squamous cell carcinoma. Presenting here a case of a male with Necrotizing sialometaplasia who was anxious because of cancerphobia as he was a smoker.

Bulimia is an eating disorder with a great prevalence in young women. Due to its multifactor ethiology, bulimia has systemic consequences. In the literature, necrotising sialometaplasia is seldom associated with bulimia. Its etiopathogenesis is discussed by several authors; nevertheless, the consensus does not consider the relevance of local trauma associated with induced vomiting. A case of necrotising sialomethaplasia, presented with a single hard palatal ulcer in a bulimic woman is described in the present report. The patient did not present significant systemic laboratorial values, nor physical weight variations, which highlights the relevance of performing a complete medical clinical history when diagnosing this rare pathology This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license info:eu-repo/semantics/publishedVersion

Nekrotizan sialometaplazi, minor tukruk bezlerinden kaynaklanan oldukca nadir, benign, inflamatuar bir hastalik olup gorunum olarak malign lezyonlara benzemektedir. Intralezyonel steroid ile tedavi edilen damak yerlesimli nadir bir nekrotizan sialometaplazi olgusu sunulmaktadir. Altmis bes yasinda erkek hastada 2 haftadir damaginda iyilesmeyen orta hatta yakin yaklasik 1x 2 cm boyutlu ulsere lezyon goruldu. Lezyondan alinan biyopsi sonucu nekrotizan sialometaplazi ile uyumlu olarak kaydedildi. Hastaya tek sefer intralezyonel 40 mg triamsinolon asetonid tedavisi uygulandi. Tedavi sonrasi ikinci haftada lezyonun tamamen iyilestigi izlendi. Nekrotizan sialometaplazi inflamatuar bir hastalik olup maligniteleri taklit edebilmektedir. Kendiliginden iyilesme mumkun olup 4 ila 10 hafta arasinda degismektedir. Intralezyonel steroid uygulamasi iyilesmeyi hizlandiran bir tedavi secenegi olarak bu nadir hastalikta goz onunde bulundurulabilir.

Necrotizing sialometaplasia is a rare lesion that mimics malignant neoplasm, which is characterized by salivary gland metaplasia, necrosis, and inflammation. We present a case of necrotizing sialometaplasia that presented as an ugly ulcer at the junction of the soft and hard palates; the lesion was clinically suspected to be a malignant lesion. A 62-year-old man was referred to our department with a complaint of severe pain during swallowing. A crater-like ulcer lesion was observed extending from the maxillary tuberosity to the soft palate. Histopathological diagnosis of necrotizing sialometaplasia was confirmed on biopsy. This lesion was spontaneously relieved.

Necrotizing sialometaplasia (NS) is a rare condition which can be easily confused with malignancy. Its presentation initially parallels mucoepidermoid carcinoma or squamous cell carcinoma, however, NS is a benign, self-limiting inflammatory disease of the mucus-secreting minor salivary glands. NS is thought to be caused by trauma which induces vascular ischemia of these minor salivary glands. Diagnosing NS continues to be difficult, and clinical history remains one of the pillars of ruling out cancer. This report details a case of NS in a 37-year-old male who presented to the Womack Army Medical Center Oral and Maxillofacial Surgery Clinic with an exophytic mass in his right-hand palate. He had a history of recent trauma induced to the area via incision and drainage to address what was believed to be a palatal space infection. Later, an incisional biopsy was performed after the exophytic mass persisted. The initial local pathology report favored low-grade mucoepidermoid carcinoma, but after review by the Joint Pathology Center at Walter Reed Military Medical Center, the consensus diagnosis was established as NS. The patient returned to the clinic five weeks later with the exophytic mass no longer present and the biopsy site healing well.

Subacute Necrotising Sialadenitis (SANS) is a self-limiting, inflammatory disorder of minor salivary glands of unknown etiology. Minor salivary glands over soft and hard palate are most commonly affected. SANS shares considerable clinical features with necrotizing sialometaplasia, which is also the commonest differential diagnosis. We present an intriguing case of soft palate SANS in a 55 year old lady.

A 27-year-old woman presented with the chief complaint of severe pain in the palate region, which had been present for two months. Upon examination, she was found to have a firm, non-ulcerated nodule measuring about 2.5cm at the palatal junction. Incisional biopsy was recommended because the clinical differential diagnosis was mucoepidermoid carcinoma or squamous cell carcinoma. Anatomopathological examination revealed squamous metaplasia of the salivary gland ducts with preservation of the lobular architecture. Immunohistochemistry showed metaplastic ducts with low reactivity for p53 and Ki67, as well as positivity for CK AE1/AE3, CK7, p63, S-100, and SMA. The final diagnosis was necrotizing sialometaplasia. No treatment is required for this disease. Thirty-nine days after biopsy, total remission was observed with no signs of relapse after two years.

Necrotising sialometaplasia is a rare inflammatory pathology of accessory salivary glands. It occurs exceptionally on the other main salivary glands. The aetiology remains to be determined. We report the case of a 37-year-old patient who came to consult for a wound and oral pain that had been evolving for 4 months. Exobuccal examination showed nothing peculiar. The intraoral examination showed an ulceration of the palatal mucosa, non-indurated, elevated, with a yellow background. Despite these signs and the absence of a history of alcohol and tobacco consumption, bleeding and lymphadenopathy, we evoked the diagnosis squamous cell carcinoma of palate. An excision biopsy was performed to confirm the diagnosis of necrotising sialometaplasia. The postoperative course was simple. In front of a palatal ulcer with raised mucosa, not indurated, not bleeding, with a yellowish background, it is necessary to think of a sialometaplasia.

Objective Necrotizing sialometaplasia (NS) is an uncommon benign process which affects minor and, more rarely, major salivary glands. While self-limiting, the condition might be clinically and histologically mistaken for malignancy. Furthermore, NS may accompany neoplasms. The aim of this paper was to report a series of Italian patients affected by NS associated with an unusual high presence of neoplasms of minor and major salivary glands. Study design Clinical and histological features of twelve patients with NS were retrospectively evaluated. Results Eight patients presented NS of the minor salivary glands of the palate, and two of them had associated neoplasms (pleomorphic adenoma and adenoid cystic carcinoma) at the same site. Four patients had NS of the parotid gland associated with a history of fine-needle aspiration biopsy performed to diagnose parotid neoplasms. These were epithelial-myoepithelial carcinoma, adenoid cystic carcinoma, Warthin's tumor, and oncocytoma, respectively. Conclusion Tumors of minor and major salivary glands might be associated with NS more frequently than previously reported. While NS of the parotid is generally the result of invasive diagnostic procedure and is detected after the excision of the tumor, NS of the minor salivary glands may obscure an underlying neoplasm, resulting in delays in referral or treatment.

Background Warthin tumor is a common, benign, painless salivary gland neoplasm. Rarely, Warthin tumors show large areas of squamous metaplasia; such Warthin tumors are called metaplastic or infarcted Warthin tumors because they are occasionally accompanied with tumor necrosis. The histological distinction between mucoepidermoid carcinomas and the metaplastic portions of Warthin tumors can be challenging; without a genetic study, mucoepidermoid carcinomas can be misdiagnosed as metaplastic Warthin tumors. We report a case of infarcted Warthin tumor partly showing mucoepidermoid carcinoma-like epithelial metaplasia. Only two cases of infarcted Warthin tumor similar to our case have been reported. Case presentation A 69-year-old Japanese man presented with a right parotid tumor. He had noticed the swelling on his right buccal region 1 year previously; the lesion had rapidly enlarged, with associated pain, 1 month previously. A radiological examination revealed a mass in the tail of the right parotid gland. Superficial parotidectomy was performed. On histological examination, the mass showed typical focal features of Warthin tumor; other areas showed coagulation necrosis of the tumor. These areas were surrounded by non-oncocytic epithelium comprising squamous and mucinous epithelial cells. Although cellular atypia of the non-oncocytic epithelium was not observed, a mixture of squamous and mucinous cells and lack of abundant lymphoid tissue mimicked low-grade mucoepidermoid carcinoma. Based on the results of fluorescence in situ hybridization, MAML2 gene rearrangement was not present in the typical portions of Warthin tumor and the mucoepidermoid carcinoma-like lesion. Therefore, a metaplastic or infarcted Warthin tumor was diagnosed. Our patient was disease-free 8 months after surgery. Conclusions Clinicians need to know that pain is a clinical symptom of infarcted/metaplastic Warthin tumor. Pathologists should be aware that a metaplastic Warthin tumor can mimic a low-grade mucoepidermoid carcinoma. Our case showed a mucoepidermoid carcinoma-like lesion that was confined near the area of tumor necrosis, and neither cytological atypia nor apparent invasive growth was present. These findings appeared to be histological clues of a metaplastic Warthin tumor rather than a mucoepidermoid carcinoma. Careful clinicopathological evaluation as well as genetic studies are needed to clarify the distinction between mucoepidermoid carcinoma and metaplastic portions of Warthin tumors.

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.