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11/28. Necrotizing sialometaplasia in the mouth floor secondary to reconstructive surgery for tongue carcinoma.

    Necrotizing sialometaplasia is a benign inflammatory process, which histologically can mimic squamous cell carcinoma. A 63-year-old man underwent left hemiglossectomy involving transplantation of a myocutaneous flap for squamous cell carcinoma of the tongue. One month after the operation, necrotizing sialometaplasia occurred in the minor salivary gland tissue of the mouth floor, compressed by the necrotic flap. This case is very unusual because of the occurrence of necrotizing sialometaplasia in the floor of the mouth. The etiology of the lesion was considered to be ischemia secondary to compression by the necrotic myocutaneous flap. ( info)

12/28. Necrotizing sialometaplasia occurring during pregnancy: report of a case.

    A case of NSM presenting as bilateral ulceration of the palate developing in the seventh month of pregnancy is reported. The lesions caused initial problems of differential diagnosis because they were more extensive than is often the case in NSM. However, healing followed simple palliative treatment for the ulcers. The etiology of NSM is discussed in relation to the vascular and hormonal changes of pregnancy. ( info)

13/28. Necrotizing sialometaplasia masquerading as residual cancer of the lip.

    Necrotizing sialometaplasia is a benign disorder that histologically can mimic carcinoma. It is thought to develop as a result of ischemia or adjacent tissue injury. A patient is described who underwent a Mohs' micrographical fresh-tissue excision of one-third of the upper lip for basal cell carcinoma. By the time she was ready for reconstruction, a marked eczematous reaction developed to a polymyxin neomycin preparation (Neosporin ointment) at the wound edges. Reexcision of the wound margins before a flap reconstruction revealed necrotizing sialometaplasia on histopathological examination. This incidental finding fortunately was not mistaken for residual tumor. To prevent over-diagnosis and over-treatment of presumed malignancies, an awareness of necrotizing sialometaplasia is essential for all surgeons operating on mucosal surfaces in the head and neck. ( info)

14/28. Posttraumatic lobular squamous metaplasia of breast. An unusual pseudocarcinomatous metaplasia resembling squamous (necrotizing) sialometaplasia of the salivary gland.

    Squamous metaplasia arising in nonneoplastic breast parenchyma is reportedly rare. We present a unique case which occurred following severe blunt trauma to the right breast of a 59-yr-old woman. The lesion contained sheets of squamous cells with a lobular growth pattern, bland cytology with few mitoses, and keratin and keratohyalin granules. It bore a striking resemblance to squamous (necrotizing) sialometaplasia of the salivary gland in that it exhibited lobular, pseudocarcinomatous growth. The patient has remained free of disease 49 mo after segmental resection of the lesion. Four previous cases of squamous metaplasia of the female breast have been reported, though none presented with a history of trauma or previous surgical manipulation. It is important to differentiate this entity from pure squamous cell carcinoma, and metaplastic change in ductal breast carcinoma, fibroadenoma, and other lesions. breast aspiration biopsies revealing squamous cells cannot exclude carcinoma; thus, caution must be exercised. ( info)

15/28. Necrotizing sialometaplasia.

    A case of necrotizing sialometaplasia in a 29-year-old man is reported. Characterized by large, deep, well-demarcated ulcerations on the hard palate and other areas where salivary gland tissue is found, the condition is benign and resolves spontaneously. The cause is believed to be infarctive. ( info)

16/28. Necrotizing sialometaplasia--a malignancy simulating oral lesion.

    A case of necrotizing sialometaplasia is reported in a 63-year-old white male. The lesion appeared as an ulcerated and painful lesion inside the left ramus mandibulae. An incisional biopsy was performed and reported as well-differentiated squamous cell carcinoma. A few days after the initial biopsy was taken the necrotizing tissue disappeared and the ulcer started to heal. A new, excisional biopsy was performed. The initial diagnosis was revised and the lesion reported as necrotizing sialometaplasia. Two weeks after the excisional biopsy complete healing was obtained. The clinical and histological findings are discussed in relation to the different stages through which a necrotizing sialometaplasia might develop. From a differential diagnostic point of view it is important for both the clinician and pathologist to be aware of the lesion's behaviour during the different stages of development. ( info)

17/28. Necrotizing sialometaplasia obscuring an underlying malignancy: report of a case.

    Necrotizing sialometaplasia poses many diagnostic problems, both clinically and microscopically. Caution had most frequently been urged for distinguishing between malignancy and NS, so as to avoid mutilating surgical treatment resulting from the misdiagnosis of a lesion that is benign and self-limiting. This case has been presented to alert the practitioner to the possibility that NS may obscure an underlying malignant disease process, possibly resulting in delays in referral or treatment. The exceedingly rapid growth of this mesenchymal neoplasm may have caused obstruction of the blood supply to the overlying mucosa and submucosa, thereby producing the ischemic alterations observed in the first biopsy specimens. Some of the difficulties encountered in the detection and diagnosis of neoplasms arising in the parapharyngeal space were discussed, and some previously published suggestions to aid in these efforts were reiterated. ( info)

18/28. Necrotizing sialometaplasia: a case with metachronous lesions.

    A case of two episodes of necrotizing sialometaplasia occurring metachronously in a single patient has been reported. The clinical and histologic features of these lesions are described and discussed in relation to the spectrum of presentations of the condition. ( info)

19/28. Necrotizing sialometaplasia: a sheep in wolf's clothing. Healing as a diagnostic test.

    Necrotizing sialometaplasia is a benign self-limited intraoral lesion that is easily confused both clinically and histologically with squamous cell carcinoma. It presents as a painless ulceration, frequently on the hard palate, that histologically shows necrosis, inflammation, squamous metaplasia, and granulation tissue. It is thought to be due to infarction of minor salivary glands and heals spontaneously in six to 12 weeks. A brief period of observation for evidence of healing can be an important diagnostic clue in distinguishing this entity from cancer, thus saving the patient unnecessary surgery or radiation therapy. ( info)

20/28. Necrotizing sialometaplasia.

    Necrotizing sialometaplasia is a benign inflammatory disease of salivary gland origin. Because of its clinical and histologic resemblance to squamous cell carcinoma, this disease must be recognized. The cause is unknown, but it may be related to oral trauma, tobacco use or inadequate blood supply. The lesion heals spontaneously, regardless of therapy, in two to eight weeks. ( info)
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