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OMFP 2 NS

Necrotizing Sialometaplasia

QuestionAnswer
Necrotizing Sialometaplasia A reactive lesion that is a locally destructive and affects the salivary glands, likely due to ischemia of the salivary glands when there is lack of blood supply. It is an inflammatory condition.
Clinical features of Necrotizing Sialometaplasia The lesion presents first as a painful non-ulcerated swelling, then after 2-3 weeks it ulcerates leaving a crater. This can be caused by trauma, dental injections, upper respiratory infections, ill-fitting dentures, adjacent tumors or previous surgeries.
Demographics of Necrotizing Sialometaplasia Average age is 43 years old, with a 2:1 ratio of Male to Female. 75% of cases occur on the palatal salivary glands of the posterior hard palate. Two thirds of these cases are unilateral.
Diagnosis Necrotizing Sialometaplasia To make a diagnosis, look at patient history, clinical correlation and radiographs to rule out other conditions, biopsy for definitive diagnosis.
Microscopic Features of Necrotizing Sialometaplasia Biopsy will reveal an ulcerated surface with loss of epithelial continuity, salivary tissue with acinar necrosis will be present in underlying connective tissue in early lesions, in long-term lesions see squamous metaplasia of the salivary duct epithelium
Treatment and Prognosis for Necrotizing Sialometaplasia After biopsy to rule out other condition there is no treatment necessary, the lesions usually resolve on their own in about 5-6 weeks. Prognosis is good with correct diagnosis and the lesions should heal with no recurrence.
Differential Diagnosis for Necrotizing Sialometaplasia The differential includes TUGSE, squamous cell carcinoma, deep fungal infection, salivary gland malignancy and metastatic cancers.
Created by: a.juarez
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