A case report of necrotizing sialometaplasia with immunohistological findings and a review of the literature

Abstract

Abstract:We report a case of necrotizing sialometaplasia arising as bilateral ulcers in the palate of a 20-year-old Japanese female patient. Based on histopathological and immunohistochemical findings, we discuss how to distinguish the condition from neoplastic lesions such as squamous cell carcinoma or mucoepidermoid carcinoma. Histopathologically, the ulcer bed of granulation tissue contained hyperplastic capillary vessels, inflammatory cell infiltrates, necrotizing and degenerating palatal glands, and squamous metaplasia of ducts and acini leaving lobular structures of the mucous gland. Immunohistochemically, the epithelial islands were positive for pancytokeratin (CK), CK7 and S-100 protein, partially positive for α-smooth muscle actin, and not positive for periodic acid-Schiff reaction. We diagnosed the lesion as a necrotizing sialometaplasia. It healed spontaneously without treatment, and there was no recurrence.

A Case of Necrotizing Sialometaplasia of the Hard Palate Treated with Tranexamic Acid and Sodium Azulene Sulfonate

“…Calponin and p-63 were detected in all stages of the salivary gland, preventing needless surgical resection. Immunohistochemical staining showed that p-63 positivity of the residual myoepithelial cells and CK-7 positivity of the metaplastic epithelial islands and the salivary ducts can help distinguish necrotizing sialometaplasia from similar conditions such as squamous cell carcinoma and mucoepidermoid carcinoma 8 .…”

Necrotizing Sialometaplasia of the Hard Palate in a Patient Treated with Topical Nonsteroidal Anti-Inflammatory Drug

“…This lesion was first described in 1973 by Abrams et al [1]. However, it may be confused with malignant lesions both histopathologically and clinically, in particular squamous cell carcinoma and mucoepidermoid carcinoma [2]. …”

Necrotizing sialometaplasia of palate: a case report

“…These lesions are relatively rare and benign. However, may be confused with malignant lesions both histopathologically and clinically, particularly squamous cell carcinoma and mucoepidermoid carcinoma [3,4]. We report the clinical and histopathological features of a case of necrotizing sialometaplaia of the hard palate in a young adult man.…”