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1/28. First case of full-thickness palatal necrotizing sialometaplasia.

    Necrotizing sialometaplasia is an uncommon, benign, self-limiting condition which can stimulate malignancy. The commonest site of occurrence is the hard palate. We report the first case with full thickness palatal involvement. The clino-pathological features of this condition are discussed. ( info)

2/28. Necrotizing sialometaplasia of parotid gland: a possible vasculitic cause.

    Necrotizing sialometaplasia at the parotid gland location is rare and simulates malignant disease. If it is seen at this location, the causes may be previous dental or parotid gland surgical procedures, which result in blood vessel injuries and thrombosis. We report a parotid gland necrotizing sialometaplasia of a 17-year-old girl, possibly caused by primary vascular damage or vasculitis. ( info)

3/28. A case of necrotizing sialometaplasia in the upper lip.

    Necrotizing sialometaplasia is a benign, reactive, and self-limiting inflammatory disorder with clinical and histologic features resembling carcinoma. A fifty-eight-year-old woman presented with a firm submucosal mass on the right side of the upper lip, measuring 0.5 cm. Histopathologic examination of the incisional biopsy specimen was reported as adenoid cystic carcinoma, resulting in removal of the mass with a large excision and reconstruction of the primary site. However, final histopathologic diagnosis of the excised mass was necrotizing sialometaplasia. No recurrences occurred during a three-year follow-up. This report draws attention to the difficulty in distinguishing between necrotizing sialometaplasia and adenoid cystic carcinoma. ( info)

4/28. Subacute necrotizing sialadenitis: a form of necrotizing sialometaplasia?

    OBJECTIVES: To report our experience of subacute necrotizing sialadenitis (SANS), an unusual lesion of the minor salivary palatal glands, and to discuss its relationship with necrotizing sialometaplasia (NS). DESIGN: A retrospective review of records for patients with SANS identified between 1996 and 2001. SETTING: Academic center, referral center, and an ambulatory care center. patients: Three patients (1 woman, 2 men), aged 22, 23, and 40 years at diagnosis. INTERVENTION: All 3 patients underwent incisional biopsy. MAIN OUTCOME MEASURES: Clinical description of SANS, ability to make the diagnosis preoperatively, clinical evolution, histologic features, and comparison with the much more frequent NS. RESULTS: Three patients presented with a lateral palatal nodule (1 case bilateral, 1 case ulcerated) of 7 to 10 days' duration, 0.8 to 1.0 cm in size, slightly or not painful. No patient was correctly diagnosed prior to undergoing a biopsy. In all 3 cases, the biopsy specimen showed acinic necrosis surrounded by a dense polymorphous inflammatory infiltrate with atrophy of ductal cells but no squamous metaplasia. Healing occurred without any further treatment in up to 3 weeks. No recurrence was observed in 2 cases; 1 patient was lost to follow-up. CONCLUSIONS: SANS is a painful spontaneously resolving necrosis of the palatal salivary glands, easily misdiagnosed preoperatively. The main differences from NS are smaller size of lesion, scarcity of ulceration, and absence of squamous metaplasia. Although initially described as a new autonomous entity, SANS might be an early or minimal form of NS. ( info)

5/28. Necrotizing sialometaplasia (adenometaplasia) of the trachea.

    Necrotizing sialometaplasia is a benign condition first described in minor salivary glands of the soft palate with morphological changes which can be misinterpreted as squamous-cell carcinoma. Similar lesions have been subsequently reported in other locations including major salivary glands, lip, breast and skin (the term syringometaplasia has been applied for the latter). We report three cases of such a process involving submucosal glands in the trachea following prolonged translaryngeal intubation. ( info)

6/28. Necrotizing sialometaplasia: an unusual bilateral presentation associated with antecedent anaesthesia and lack of response to intralesional steroids. Case report and review of the literature.

    Necrotizing sialometaplasia is a self-limiting, variably ulcerated benign process affecting minor salivary glands. Accurate histological diagnosis is paramount, as it has been mistaken for malignancy, which has resulted in excessively aggressive and unnecessary radical surgery. A unique case of bilateral necrotizing sialometaplasia, presenting with anaesthesia of the greater palatine nerves, is described. An attempt at active therapy with intralesional steroids had no effect on the course of the condition. ( info)

7/28. Necrotizing sialometaplasia: report of five cases.

    Necrotizing sialometaplasia (NS) is a self-limiting inflammatory disease, that involves salivary glands, more frequently the minor ones. Although its etiopathogenesis remains still unknown some authors suggest that a physico-chemical or biological injury on the blood vessels may produce ischemic changes, leading to infarction of the gland and its further necrosis. Its clinical and histologic feature resemble malignancy. Clinically it may appear like an ulcer with slightly elevated irregular borders and necrotic base. Histologic features are squamous metaplasia of ducts and acini and a pseudoepitheliomatous hyperplasia of the overlying mucosa. These characteristics may induce to an inapropiated diagnosis of malignant neoplasia. A correct diagnosis to avoid mutilant surgical treatments is essential, considering that it is a self-limiting disease. In this report we describe five cases of NS in females, located in minor glands of the palate. ( info)

8/28. Sialosis and necrotising sialometaplasia in bulimia; a case report.

    Salivary gland involvement, particularly salivary gland enlargement (sialosis), is a recognised complication in bulimia. We report the rare association of sialosis and necrotising sialometaplasia with bulimia in the same patient. The association of sialosis and necrotising sialometaplasia in the same patient with bulimia has been reported previously in two patients and may be coincidental, but the appearance in this additional patient suggests it may be prudent to explore this further. ( info)

9/28. Necrotizing sialometaplasia.

    Necrotizing sialometaplasia is a benign self-limiting disorder which can simulate malignancy. We report the third such case of nasal fossa involvement in the literature. The pathology of this condition is discussed. ( info)

10/28. Necrotizing sialometaplasia associated with bulimia: case report and literature review.

    Necrotizing sialometaplasia (NSM) is a self-limiting disorder affecting mainly the minor salivary glands. The significance of NSM resides in its clinical and histopathological resemblance to carcinoma. Few cases of NSM associated with eating disorders have been reported to date. We present here the clinical features and histomorphology of an additional case of bulimia-associated NSM closely mimicking an invasive carcinoma. A high index of suspicion and good communication between clinician and pathologist are essential in recognizing this entity and preventing unnecessary surgical therapy. ( info)
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