The ensuing inflammation causes squamous metaplasia of ducts and hyperplasia of the surface stratified squamous epithelium. It appears as an aggressive looking lesion in an adult possibly resembling squamous cell carcinoma and mucoepidermoid carcinoma. Necrotizing sialometaplasia is a rare inflammatory necrotizing reactive process that can involve minor and major salivary glands. Necrotizing sialometaplasia is a rare lesion that mimics malignant neoplasm, which is characterized by salivary gland metaplasia, necrosis, and inflammation. The lesion begins acutely with swelling and pain or numbness. Although entirely benign and requiring no treatment, due. Necrotizing sialometaplasia occurred in a 55yearold woman. Most cases of necrotizing sialometaplasia appear to arise spontaneously, whereas others are associated with a history of trauma, vomiting, 18, 19 radiation therapy, or surgery. The hard palate is the commonest oral site affected. To the best of our knowledge, only 22 cases of sans have been reported, mostly on salivary palatal glands. Necrotizing sialometaplasia is an uncommon inflammatory condition that affects salivary glands.
Necrotizing sialometaplasia is a relatively uncommon oral disorder. It is thought to be the result of an ischemic event of the vasculature supplying the salivary gland lobules. An ischemic basis for necrotizing sialometaplasia is the most accepted one. Necrotizing sialometaplasia was first described in 1973 by abrams, melrose and howell1. All subsequent reports of necrotizing sialometaplasia stress the. The lesion is often misdiagnosed as malignant based on clinical and histological findings. The ulcerated lesion on the hard palate was treated conservatively and resolved spontaneously in about three months.
Subacute necrotizing sialadenitis sans is a selflimiting inflammatory lesion of the minor salivary glands of unknown cause. Often painless, the condition is selflimiting and should heal in 610 weeks. Necrotizing sialometaplasia ns is a benign, self limiting inflammatory reaction of salivary gland tissue which may mimic squamous cell carcinoma or mucoepidermoid carcinoma both clinically and histologically and can lead to unnecessary surgical approach. A further five cases were reported the following year by dunlap and barker. A case report article pdf available august 2012 with 875 reads. We report the case of a healthy 25yearold caucasian woman with a threeweek history of a painless lump on her hard palate. Necrotizing sialometaplasia is a benign, selflimited lesion of both major and minor salivary glands, although more commonly the latter. An association with neoplasia, such as parotid tumors, false vocal cord squamous cell carcinoma, and maxillary sinus carcinoma, is also reported. Today there are many polymedicated patients, and it is difficult to find. Necrotizing sialometaplasia ns is a selflimiting, benign, ischemic, inflammatory disease that is most often described in the submandibular glands of dogs, with clinical and histologic features. Necrotizing sialometaplasia of major salivary glands. Necrotizing sialometaplasia is a rare inflammatory disease of the salivary glands, the prevalence of which is estimated at 0. Necrotizing sialometaplasia radiology reference article.
Necrotizing sialometaplasians is a benign, self limiting inflammatory reaction of salivary gland tissue which may mimic squamous cell carcinoma or mucoepidermoid carcinoma both clinically and histologically and can lead to unnecessary surgical approach. Sialometaplasia definition at, a free online dictionary with pronunciation, synonyms and translation. The clinical and histopathologic features of necrotizing sialometaplasia often simulate those of malignancies such as squamous cell carcinoma or salivary gland malignancy. We report the case of a healthy 26yearold man with a painless swelling in the hard palate near the middle raphe, asymptomatic, well limited, and raised edges. It is thought to be caused by ischemic necrosis death of tissue due to lack of blood supply of minor salivary glands in response to trauma. It is considered by some authors to be a distinct entity 1,2 and by others to be part of the spectrum of necrotizing sialometaplasia ns.
Here we report a case of necrotizing sialometaplasia in a female on left side of hard palate mimicking carcinoma. Necrotizing sialometaplasia ns is a benign, selflimiting inflammatory reaction of salivary gland tissue which may mimic squamous cell carcinoma or mucoepidermoid carcinoma, both clinically and histologically, that creates diagnostic dilemma leading to unwarranted aggressive surgery. Mucus gland infarct with squamous epithelial metaplasia in the lung. A case of necrotizing sialometaplasia clinically mimicking.
Necrotizing sialometaplasia of the palate sciencedirect. The cause is local ischemia producing infarction of salivary acini. Necrotizing sialometaplasia in the setting of acute and chronic sinusitis. Ct findings of necrotizing sialometaplasia a suomalainen et al 531 dentomaxillofacial radiology.
This pathological lesion was first reported in 1973 by abrams et al. Necrotizing sialometaplasia free download as powerpoint presentation. Necrotizing sialometaplasia of hard palate a case report. Epidemiology most patients are more than 40 years of age, with.
Necrotizing sialometaplasia is a reactive lesion of salivary gland origin. Necrotizing sialometaplasia of the hard palate in a. Discussion the clinical and histopathological data in cases indicated that they were in the early infarction and necrosis stage of necrotizing sialometaplasia. Download fulltext pdf download fulltext pdf necrotizing sialometaplasia of palate. Necrotizing sialometaplasia wikipedia republished wiki 2. We present a case of necrotizing sialometaplasia that presented as an ugly ulcer at the junction of the soft and hard palates. Necrotizing sialometaplasia uncommon locally destructive inflammatory condition of the salivary glands. The aim is to add to the existing literature on this condition. The symptoms were modest with swelling covered by intact mucosa. It predominantly affects salivary tissue and usually involves the palate, although it has. The vast majority of cases occur on the posterior lateral hard palate. Necrotizing sialometaplasia definition of necrotizing. Thus, there are no studies on the incidence of the condition.
The characteristic clinical presentation of necrotizing sialometaplasia is due to nonneoplastic ulceration of tissues overlying minor salivary glands. The tumor did not resemble the subsequent ulcerative lesion diagnosed as necrotizing sialometaplasia. Some predisposing factors such as smoking, use of alcohol, denture wearing, recent surgery, traumatic injuries. Necrotizing sialometaplasia is a benign, selflimiting and rare inflammatory disease which, on clinical and histological examination, mimics malignant neoplasms.
She had been aware of numbness in the right hard plate before this visit. Download fulltext pdf necrotizing sialometaplasia of tongue article pdf available in journal of oral and maxillofacial pathology 1. Discussion all previous reports on necrotizing sialometaplasia dealt with specific cases of the condition. Necrotizing sialometaplasia necrotizing sialometaplasia. In 1973, abrams et al first reported this condition. Case report ct findings of necrotizing sialometaplasia. Necrotizing sialometaplasia as a cause of a nonulcerated.
Necrotizing sialometaplasia is a benign inflammatory process that involves the minor salivary glands, primarily those of the hard palate. The prevalance of necrotizing sialometaplasia was 0. Necrotizing sialometaplasia international journal of. The lesion occurs due to vascular ischemia caused by trauma. A rare site of socalled necrotizing sialometaplasia. Necrotizing sialometaplasia ns is a benign selflimiting inflammatory condition which can be found at any site in the body that contains elements of the salivary glands, 1,2 the most common site being the palatal mucosa. A 21yearold woman visited a family dentist complaining of swelling and pain in the right hard palate. Mostly it occurs in the palate and also salivary glands. A 38yearold man with bilateral ulcerative painful lesions at the junction of the hard and soft palate was presented. Necrotizing sialometaplasia necrotizing sialometaplasias. Sialometaplasia definition of sialometaplasia by medical. Necrotizing sialometaplasia nsm is an uncommon inflammatory condition that affects salivary glands. This is caused due to the less blood supply to the salivary glands.
Physicians should be aware of its clinical and histological traits in order to avoid unnecessary disfiguring surgery. Lisa franklin is an oral pathologist who presented a forensics lecture to the residency. Franklin has a great style of presentation, and i felt it was important to show others that oral. Necrotizing sialometaplasia ns is a nonneoplastic inflammatory condition of the salivary glands. Necrotizing sialometaplasia affects the salivary glands. The major importance of this condition is the danger of misdiagnosis, because it may clinically and histologically mimic a malignancy. Download fulltext pdf necrotizing sialometaplasia of palate. A case report article pdf available in imaging science in dentistry 411. This relatively rare condition holds diagnostic importance because of its ambiguous clinical and histopathological presentation that can be misdiagnosed clinically as neoplasia. Necrotizing sialometaplasia is a benign inflammatory condition of the salivary gland remnants or elements, which is usually selflimiting.
Necrotizing sialometaplasia ns is an uncommon benign reactive necrotizing inflammatory process involving minor salivary gland that often mimics malignancy both clinically and histopathologically. Necrotizing sialometaplasia ns is a benign, ulcerative lesion, usually located towards the back of the hard palate. Necrotizing sialometaplasia a diagnostic conundrum. The histology of the lesion consisted of coagulative necrosis of the salivary gland lobules and prominent squamous metaplasia within adjacent viable lobules. It can represent a diagnostic dilemma and may be mistaken for a malignant neoplasm, such as mucoepidermoid carcinoma, as well as. A case of necrotizing sialometaplasia ns is presented in a female patient, who initially presented as a suspected head and neck malignancy. Necrotizing sialometaplasia is a reactive, inflammatory, nonneoplastic process that arises from ischemic necrosis of minor salivary glands. Necrotizing sialometaplasia ns is a benign disease showing inflammatory response which occurs in minor salivary glands mimicking a malignant lesion both clinically as well as histopathologically. Necrotizing sialometaplasia is a rare, benign inflammatory disease of the minor mucous salivary glands usually caused by glandular ischemia or trauma, that can mimic malignancy, but has a selflimiting character. Pdf necrotizing sialometaplasia of the parotid gland in.
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