Atypical Presentation of Necrotizing Sialometaplasia of the Hard Palate: A Diagnostic Dilemma

Necrotizing sialometaplasia refers to a benign, uncommon, and self-limiting inflammatory reaction concerning the salivary gland tissue, which both clinically and histologically may be easily mistaken for mucoepidermoid carcinoma or squamous cell carcinoma. This may cause irrelevant surgical intervention. Minor salivary glands are the most commonly affected salivary gland, with the hard palate being the most usual site. However, it can involve the other areas in which salivary gland tissue is present in the other oral subsites and pharyngeal areas. Due to the lack of knowledge about this entity and its histological similarities with carcinomas, particularly mucoepidermoid carcinoma, the differential diagnosis of this lesion is difficult. Local ischemia is thought to be the primary cause, leading to the pathogenesis of necrotizing sialometaplasia, and the infiltration of local anesthesia following dental procedures at the palatal region is the leading cause.