NECROTIZING SIALOMETAPLASIA OF SOFT PALATE: IT IS STILL A DIAGNOSTIC DILLEMA

• Published in: Oral surgery, oral medicine, oral pathology and oral radiology Vol. 137; no. 6; pp. e157 - e158
• Main Authors: LOUREIRO, Caio Cesar de Souza, de SOUZA JÚNIOR, Alberi José Thomas, ROCHA, Patrícia Bitencourt DA, RIBEIRO, Jaqueline Lemes, ANBINDER, Ana Lia
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.06.2024
• ISSN: 2212-4403; 2212-4411
• DOI: 10.1016/j.oooo.2023.12.046

Necrotizing sialometaplasia (NSM) is a rare self-limited lesion of the salivary glands, which can be easily misdiagnosed as a malignant neoplasm, such as mucoepidermoid and squamous cell (SCC) carcinomas. We hereby report a case of NSM in a 45-year-old man presenting with a soft palate ulcer and the diagnostic hypothesis of syphilis or SCC. After an incisional biopsy, histological sections revealed a fragment lined by hyperplastic squamous epithelium with drop-shaped rete ridges and disorganization of the basal layer. An extensive ulcerated area and small nests of squamous cells with slight cellular atypia and mitotic figures were observed beneath it, as well as ducts and small groups of mucous and squamous cells. Immunohistochemistry for calponin and smooth muscle actin demonstrated myoepithelial cells surrounding the epithelial islands. Complete resolution was observed after 5 weeks, confirming the diagnosis of NSM. Awareness of the similarities of this lesion with malignant neoplasms is important to avoid diagnostic pitfalls and mistreatment.