J Korean Assoc Oral Maxillofac Surg.  2015 Dec;41(6):338-341. 10.5125/jkaoms.2015.41.6.338.

Contralateral recurrence of necrotizing sialometaplasia of the hard palate after five months: a case report

• Jeong CW
• Youn T
• Kim HS
• Park KH
• Huh JK

• KMID: 2133182
• DOI: http://doi.org/10.5125/jkaoms.2015.41.6.338

Abstract

Necrotizing sialometaplasia usually heals within 4 to 10 weeks with conservative treatment, and rarely recurs. When necrotizing sialometaplasia is present on the hard palate it may occur unilaterally or bilaterally. In this case, necrotizing ulceration occurred on the left hard palate of a 36-year-old woman after root canal treatment of the upper left first premolar under local anesthesia. After only saline irrigation the defect of the lesion completely healed and filled with soft tissue. After 5 months, however, a similar focal necrosis was found on the contralateral hard palate without any dental treatment having been performed on that side and progressed in similar fashion as the former lesion. We conducted an incisional biopsy and obtained a final pathological diagnosis for the palatal mass of necrotizing sialometaplasia. At the 3-year follow-up, the patient's oral mucosa of the hard palate was normal, without any signs and symptoms of the condition. We report a case of a second occurrence of necrotizing sialometaplasia on the contralateral side from the first, with a time lapse between the first and second occurrence.

Keyword

Necrotizing sialometaplasia; Palate

MeSH Terms

Adult
Anesthesia, Local
Bicuspid
Biopsy
Dental Pulp Cavity
Diagnosis
Female
Follow-Up Studies
Humans
Mouth Mucosa
Necrosis
Palate
Palate, Hard*
Recurrence*
Sialometaplasia, Necrotizing*
Ulcer

Figure

• 

  Fig. 1 A. Ulceration on left hard palate of the patient at the first visit. B. Necrotic tissue detached from the lesion spontaneously. C. Normal healing of the lesion three weeks after the first visit.

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  Fig. 2 A. Recurrent lesion on the right hard palate five months after the initial visit. The lesion on the left side had healed well. B. Incisional biopsy was performed. C. Complete healing of bilateral hard palate necrotizing sialometaplasia at 3-year periodic check-up.

• 

  Fig. 3 Histopathologic findings. A. The lobular structure of the salivary gland is preserved, but the salivary gland showed diffuse necrosis of acini and duct (arrowhead). A mucin pool was also identified (arrow) (H&E staining, ×40). B. Chronic inflammatory cell infiltrates around the necrotic acini and ducts (H&E staining, ×200).

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