Monday 18 March 2013
Definition: Necrotizing sialometaplasia is a benign, self-healing process of unknown etiology.
Ischemia is thought to play some role in its development. It is self-limiting, and no treatment is required. It typically involves the minor salivary glands of the hard palate but may occur in salivary tissue elsewhere.
Presentation is usually as an asymptomatic mucosal ulceration or nodular lesion of the hard palate which may be misstaken clinically and histologically for a malignant neoplasm, especially squamous cell carcinoma or mucoepidermoid carcinoma.
Histologically, lobular necrosis is present with squamous metaplasia of the remaining acini and ductal elements. This metaplasia is bland in appearance and native lobular architecture is maintained. Pseudoepitheliomatous hyperplasia may also be seen.
Biopsy may be required to establish the diagnosis and may present diagnostic difficulties.