Necrotizing sialometaplasia masquerading as residual cancer of the lip.
Necrotizing sialometaplasia is a benign disorder that histologically can mimic carcinoma. It is thought to develop as a result of ischemia or adjacent tissue injury. A patient is described who underwent a Mohs' micrographical fresh-tissue excision of one-third of the upper lip for basal cell carcinoma. By the time she was ready for reconstruction, a marked eczematous reaction developed to a polymyxin neomycin preparation (Neosporin ointment) at the wound edges. Reexcision of the wound margins before a flap reconstruction revealed necrotizing sialometaplasia on histopathological examination. This incidental finding fortunately was not mistaken for residual tumor. To prevent over-diagnosis and over-treatment of presumed malignancies, an awareness of necrotizing sialometaplasia is essential for all surgeons operating on mucosal surfaces in the head and neck.
Granick
M S
MS
Department of Surgery (Plastic), Graduate Hospital, Philadelphia, PA.
Solomon
M P
MP
Benedetto
A V
AV
Hannegan
M W
MW
Sohn
M
M
D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000601:surgery*; D005260:Female; D006801:Humans; D008046:Lip / Q000473:pathology; D008048:Lip Neoplasms / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011183:Postoperative Complications / Q000473:pathology*; D012086:Reoperation; D012466:Salivary Gland Diseases / Q000473:pathology*; D012797:Sialometaplasia, Necrotizing / Q000473:pathology* / Q000601:surgery; D013524:Surgical Flaps; D014945:Wound Healing