Necrotizing sialometaplasia - Oral Mucosal Lesion
Patients may have a spectrum of symptoms, but usually patients initially notice a unilateral area of swelling of the posterior hard palate. This may be accompanied by a sensation of pain, paresthesia, or numbness. Subsequently, the necrotic tissue sloughs off leaving an ulcer and granulation tissue, and healing ensues. Some investigators have suggested that cigarette smoking may be a risk factor for this condition. Other associations include excessive use of local anesthesia with vasoconstrictors, Buerger disease, and bulimia.
Necrotizing sialometaplasia usually evolves rather quickly, and after the ulceration develops, healing by secondary intention may take weeks or 1-2 months, depending on the size of the defect.
K11.8 – Other diseases of salivary glands
109769000 – Necrotizing sialometaplasia
- Squamous cell carcinoma – The posterior hard palate would be an unusual site for this malignancy, and the sudden onset would be peculiar.
- Salivary gland tumor, malignant – The sudden onset of the lesion would be unusual, and the absence of a tumor mass would suggest necrotizing sialometaplasia.
- Salivary gland tumor, benign
- Non-specific traumatic ulcer such as from a pizza burn
- Traumatic ulcerative granuloma (particularly if the lesion is on the tongue)
- Herpes simplex – These ulcers tend to be grouped, coalescent, and 1-3 mm in size.
- Herpes zoster infection (oral shingles) – These ulcers tend to be grouped, coalescent and 1-3 mm in size without a crateriform tissue defect.
- Non-Hodgkin lymphoma – T-cell lymphoma can also produce tissue destruction, but the sudden onset would be unusual.
- Vasculitides such as ANCA-associated granulomatosis (granulomatosis with polyangiitis) – The sudden onset would be unusual, and other signs (such as epistaxis) might be expected.
- Specific infection (tuberculosis or deep fungal) – Sudden onset would be unusual for these conditions, and the patient would usually have other systemic signs and symptoms.