Sialometaplasia necrotizingK11.8
Synonym(s)
Necrotizing sialometaplasia; sialometaplasia
HistoryThis section has been translated automatically.
Abrams et al., 1973
DefinitionThis section has been translated automatically.
Sudden, painful, sharply defined ulcer formation in the area of the A. palatina maior (usually at the transition from hard to soft palate).
EtiopathogenesisThis section has been translated automatically.
Thrombosis of a palatal artery with creeping necrosis of submucous salivary glands and consecutive necrosis of the surface epithelium. This can be caused by prosthesis pressure, drug-induced vasospasms (e.g. after ganglion stellatum blockage) or system vasculitis ( endangiitis obliterans). Occurrence is more frequent in smokers.
ManifestationThis section has been translated automatically.
Occurring in middle age (40-50 years).
LocalizationThis section has been translated automatically.
The oral mucosa (central location) and especially the transition from hard to soft palate are affected.
Clinical featuresThis section has been translated automatically.
Sudden, pulling pain in the area of the central palate (typically at the transition from soft to hard palate). After a few days, circumscribed erythema followed by sharply defined, initially flat, later possibly also deep, widely punched ulcer formation. Healing within a few weeks leaving a scar.
HistologyThis section has been translated automatically.
Granulation tissue with lobular aggregated (regenerative) squamous epithelial nests and remnants of mucous salivary glands. Histologically, there is a risk of misdiagnosis as squamous cell carcinoma due to regenerative squamous cell metaplasia, which is probably caused by the slow onset of necrosis of the surface epithelium.
Differential diagnosisThis section has been translated automatically.
Squamous cell carcinoma; ulcerative herpes simplex; syphilitic primary effect; Lues III; Wegener's granulomatosis; tuberculosis ulcerosa mucosae et cutis; leishmaniasis.
Complication(s)This section has been translated automatically.
Rare are accompanying paresthesias of the face and intermittent visual disturbances.
LiteratureThis section has been translated automatically.
- Abrams AM, Melrose RJ, Howell FV (1973) Necrotizing sialometaplasia. A disease simulating malignancy. Cancer 32: 130-135
- Flint SR (2005) Necrotizing sialometaplasia: an important diagnosis--review of the literature and spectrum of clinical presentation. J Ir Dent Assoc 51: 26-28
- Keogh PV et al (2004) Necrotizing sialometaplasia: an unusual bilateral presentation associated with antecedent anaesthesia and lack of response to intralesional steroids. Case report and review of the literature. Br Dent J 196: 79-81
- Schmidt-Westhausen A et al (1991) Necrotizing sialometaplasia of the palate. Literature report of 3 new cases. German Z Mouth Jaw Face Shield 15: 30-34
- Voigtländer C et al (2007) Ulceration on the hard palate of a 50-year-old patient. dermatologist 58: 161-162
- Zschoch H (1992) Mucus gland infarct with squamous epithelial metaplasia in the lung. A rare site of so-called necrotizing sialometaplasia. Pathologist 13: 45-48