The clinical, histologic, and treatment spectrum in necrotizing sialometaplasia

ObjectivesThe aim of this report was the clinical and histologic characterization of necrotizing sialometaplasia.Study DesignWe performed a retrospective case series analysis.ResultsThe study included 4 women 29-71 years old. Possible contributing factors (drugs, alcohol abuse, bulimia, smoking, and pancreatic cancer) were identified. Patients presented with unilateral or bilateral rapidly progressing painful palatal ulcers. Necrotic salivary glands and inflammation were universal microscopic features; ductal metaplasia was present in only 1 case. Thrombosis and heavy fungal and bacterial overgrowth were observed in 1 case. In 3 of the cases the lesions healed within 4-6 weeks under conservative supportive care, whereas in 1 case persistent enlargement up to 25 mm diameter was observed. Surgical debridement combined with a palatal guard resulted in complete healing within 12 weeks.ConclusionsSignificant variations may be observed in both clinical and microscopic manifestations of necrotizing sialometaplasia. Although this disease is c