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Silva EV, Silveira HA, Moreira TPC, Augusto J, Silva PVR, Bufalino A, León JE. Non-Ulcerated and Ulcerated Necrotizing Sialometaplasia: Report of an Additional Case and Literature Review. Indian J Otolaryngol Head Neck Surg 2023; 75:2302-2305. [PMID: 37636786 PMCID: PMC10447832 DOI: 10.1007/s12070-023-03609-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/17/2023] [Indexed: 03/03/2023] Open
Abstract
Necrotizing sialometaplasia (NS) is a rare, self-limiting, necrotizing inflammatory lesion, often involving the minor salivary glands of the palate. NS occurs often in men (60%) older than 45 years. Commonly, it presents as an ulcerative lesion, measuring 1 to 3 cm in diameter, with an evolution time of a few weeks or days, simulating malignancy. However, in some instances, the mucosal surface is intact, thus emphasizing the importance of considering NS in the differential diagnosis of oral ulcerative and non-ulcerative lesions. To date, 12 cases of non-ulcerated NS in the palate have been reported. Here, we report a 50-year-old male patient who presented a non-ulcerated, asymptomatic, nodular swelling 3 months ago, located on the hard palate, clinically suggesting salivary gland tumor or lymphoproliferative disorder. After biopsy, a diagnosis of non-ulcerated NS was established. After 4 weeks, the lesion evolved with complete resolution. After literature review, notably, unlike ulcerated NS, the non-ulcerated NS affected patients a decade younger (33 years vs. 45 years), with marked female predilection (83% vs. 40%) and not uncommon bilateral presentation (33% vs. 10%). NS should be considered in the differential diagnosis of ulcerative and non-ulcerative lesions affecting the palate.
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Affiliation(s)
- Evânio Vilela Silva
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara Dental School, (UNESP), Araraquara, Brazil
- Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Avenida do Caf?, S/N, 14040-904 Ribeirão Preto, SP Brazil
| | - Heitor Albergoni Silveira
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara Dental School, (UNESP), Araraquara, Brazil
- Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Avenida do Caf?, S/N, 14040-904 Ribeirão Preto, SP Brazil
| | - Thales Peres Candido Moreira
- Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Avenida do Caf?, S/N, 14040-904 Ribeirão Preto, SP Brazil
| | - Jefferson Augusto
- Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Avenida do Caf?, S/N, 14040-904 Ribeirão Preto, SP Brazil
| | - Paula Verona Ragusa Silva
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara Dental School, (UNESP), Araraquara, Brazil
| | - Andreia Bufalino
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara Dental School, (UNESP), Araraquara, Brazil
| | - Jorge Esquiche León
- Oral Pathology, Department of Stomatology, Public Oral Health, and Forensic Dentistry, Ribeirão Preto Dental School (FORP/USP), University of São Paulo, Avenida do Caf?, S/N, 14040-904 Ribeirão Preto, SP Brazil
- Department of Pathology and Forensic Medicine, FMRP/USP), Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP Brazil
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Thandi BS, Jane R, Chavda V, Chapple ILC. Simultaneous presentation of dual pathologies within the oral cavity: an unusual and diagnostically challenging presentation. Br Dent J 2023; 235:250-254. [PMID: 37620474 PMCID: PMC10449619 DOI: 10.1038/s41415-023-6138-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/09/2023] [Indexed: 08/26/2023]
Abstract
Necrotising sialometaplasia (NS) is a rare condition, with a limited scientific evidence base regarding its aetiology and pathophysiology. Diagnosing NS demands extensive investigatory tests. Their accuracy is vital in order to exclude oral malignancy and prevent unwarranted, invasive management.Within Birmingham Dental Hospital, a 22-year-old, South Asian woman presented with generalised pain from the lower right third molar extending to involve the palate, to which the patient's general medical practitioner previously attributed to a viral upper respiratory infection. Clinical examination revealed bilateral erythematous: non-ulcerated, palatal swellings (10 mm x 5 mm) at the greater palatine foramina. Following extensive investigations, the challenging definitive diagnoses of two distinct pathologies were made: non-ulcerative NS and pericoronitis.This case report describes the successful diagnosis and management of non-ulcerating NS, an 'atypical' presentation of a rare condition, that was confounded by a simultaneous episode of pericoronitis - a presentation not previously documented within scientific literature.
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Affiliation(s)
- Beant Singh Thandi
- School of Dentistry, University of Birmingham, Birmingham, United Kingdom
| | - Rosemarie Jane
- School of Dentistry, University of Birmingham, Birmingham, United Kingdom
| | - Vinay Chavda
- School of Dentistry, University of Birmingham, Birmingham, United Kingdom
| | - Iain L C Chapple
- School of Dentistry, University of Birmingham, Birmingham, UK; Periodontal Research Group, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, United Kingdom.
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Muacevic A, Adler JR, Fenn SM, Pethagounder Thangavelu R. Necrotizing Sialometaplasia: A Diagnostic Challenge to Oral Physicians. Cureus 2022; 14:e33122. [PMID: 36721615 PMCID: PMC9884392 DOI: 10.7759/cureus.33122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 12/31/2022] Open
Abstract
Necrotizing sialometaplasia is a rare, reactive, self-limiting disorder affecting a minor salivary gland that clinically mimics malignancy. Chronic smoking, alcohol use, trauma to the hard palate caused by local anesthetic injection due to the vasoconstrictive action of adrenaline in local anesthetic, topical application of nonsteroidal anti-inflammatory drugs like flurbiprofen spray used in bronchial asthma, oral intubation procedures for general anesthesia, ill-fitting dentures, bulimia nervosa, and minor salivary gland tumors are some of the contributing factors linked to its development. In this article, we discuss a rare, reactive, self-limiting condition affecting minor salivary gland, necrotizing sialometaplasia that occurred on the right posterolateral hard palate region in a 57-year-old male chronic smoker, diagnosed by oral medicine specialist by clinical findings and radiological evaluation by cone beam computed tomography that healed rapidly in three days by itself without any treatment, that prevented unwanted biopsy or surgery.
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