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Necrotizing sialometaplasia: a malignant masquerade but questionable precancerous lesion, report of four cases

BACKGROUND: Necrotizing sialometaplasia (NSM) is an extremely rare benign lesion with an uncertain pathogenesis. The differential diagnosis of this lesion is challenging due to little familiarity with this entity and histologic similarity with carcinomas, especially mucoepidermoid carcinoma (MEC). T...

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Autores principales: Shin, Sun Ah., Na, Hee Young, Choe, Ji Young, Hong, Seung-No, Lee, Ho, Park, Sunwon, Kim, Ji Eun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359558/
https://www.ncbi.nlm.nih.gov/pubmed/32664899
http://dx.doi.org/10.1186/s12903-020-01189-1
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author Shin, Sun Ah.
Na, Hee Young
Choe, Ji Young
Hong, Seung-No
Lee, Ho
Park, Sunwon
Kim, Ji Eun
author_facet Shin, Sun Ah.
Na, Hee Young
Choe, Ji Young
Hong, Seung-No
Lee, Ho
Park, Sunwon
Kim, Ji Eun
author_sort Shin, Sun Ah.
collection PubMed
description BACKGROUND: Necrotizing sialometaplasia (NSM) is an extremely rare benign lesion with an uncertain pathogenesis. The differential diagnosis of this lesion is challenging due to little familiarity with this entity and histologic similarity with carcinomas, especially mucoepidermoid carcinoma (MEC). The purpose of this study is to raise awareness about NSM, which is often overlooked or misdiagnosed as malignancy in a small biopsy. METHODS: We reviewed all biopsy materials taken from the oral cavity in a single institution in Korea from 2012 to 2018 and found 4 cases of NSM out of 726. Clinicopathologic characteristics and comparison with other lesions were discussed. RESULTS: Unlike previous reports, patients in our series were relatively young, and NSM was not related to smoking and not associated with malignancies, although one patient was misdiagnosed with MEC on the basis of the initial biopsy. High-grade squamous dysplasia was observed in one patient; however, all four patients showed excellent prognoses without further management. CONCLUSIONS: A conservative approach is recommendable for necrotizing lesions of the palate in young adults to avoid unnecessary treatment. However, careful monitoring is also required due to uncertainty of premalignant potential.
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spelling pubmed-73595582020-07-17 Necrotizing sialometaplasia: a malignant masquerade but questionable precancerous lesion, report of four cases Shin, Sun Ah. Na, Hee Young Choe, Ji Young Hong, Seung-No Lee, Ho Park, Sunwon Kim, Ji Eun BMC Oral Health Research Article BACKGROUND: Necrotizing sialometaplasia (NSM) is an extremely rare benign lesion with an uncertain pathogenesis. The differential diagnosis of this lesion is challenging due to little familiarity with this entity and histologic similarity with carcinomas, especially mucoepidermoid carcinoma (MEC). The purpose of this study is to raise awareness about NSM, which is often overlooked or misdiagnosed as malignancy in a small biopsy. METHODS: We reviewed all biopsy materials taken from the oral cavity in a single institution in Korea from 2012 to 2018 and found 4 cases of NSM out of 726. Clinicopathologic characteristics and comparison with other lesions were discussed. RESULTS: Unlike previous reports, patients in our series were relatively young, and NSM was not related to smoking and not associated with malignancies, although one patient was misdiagnosed with MEC on the basis of the initial biopsy. High-grade squamous dysplasia was observed in one patient; however, all four patients showed excellent prognoses without further management. CONCLUSIONS: A conservative approach is recommendable for necrotizing lesions of the palate in young adults to avoid unnecessary treatment. However, careful monitoring is also required due to uncertainty of premalignant potential. BioMed Central 2020-07-14 /pmc/articles/PMC7359558/ /pubmed/32664899 http://dx.doi.org/10.1186/s12903-020-01189-1 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Shin, Sun Ah.
Na, Hee Young
Choe, Ji Young
Hong, Seung-No
Lee, Ho
Park, Sunwon
Kim, Ji Eun
Necrotizing sialometaplasia: a malignant masquerade but questionable precancerous lesion, report of four cases
title Necrotizing sialometaplasia: a malignant masquerade but questionable precancerous lesion, report of four cases
title_full Necrotizing sialometaplasia: a malignant masquerade but questionable precancerous lesion, report of four cases
title_fullStr Necrotizing sialometaplasia: a malignant masquerade but questionable precancerous lesion, report of four cases
title_full_unstemmed Necrotizing sialometaplasia: a malignant masquerade but questionable precancerous lesion, report of four cases
title_short Necrotizing sialometaplasia: a malignant masquerade but questionable precancerous lesion, report of four cases
title_sort necrotizing sialometaplasia: a malignant masquerade but questionable precancerous lesion, report of four cases
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7359558/
https://www.ncbi.nlm.nih.gov/pubmed/32664899
http://dx.doi.org/10.1186/s12903-020-01189-1
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