title: The clinical, histologic, and treatment spectrum in necrotizing sialometaplasia.
abstract: OBJECTIVE
  The aim of this report was the clinical and histologic characterization of necrotizing sialometaplasia.
  
  
  METHODS
  We performed a retrospective case series analysis.
  
  
  RESULTS
  The study included 4 women 29-71 years old. Possible contributing factors (drugs, alcohol abuse, bulimia, smoking, and pancreatic cancer) were identified. Patients presented with unilateral or bilateral rapidly progressing painful palatal ulcers. Necrotic salivary glands and inflammation were universal microscopic features; ductal metaplasia was present in only 1 case. Thrombosis and heavy fungal and bacterial overgrowth were observed in 1 case. In 3 of the cases the lesions healed within 4-6 weeks under conservative supportive care, whereas in 1 case persistent enlargement up to 25 mm diameter was observed. Surgical debridement combined with a palatal guard resulted in complete healing within 12 weeks.
  
  
  CONCLUSIONS
  Significant variations may be observed in both clinical and microscopic manifestations of necrotizing sialometaplasia. Although this disease is considered to be self-limiting in the majority of cases, surgical intervention can be considered in unusually large cases.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. ig_kaplan@012.net.il
authors.forename: Ilana
authors.initials: I
authors.lastname: Kaplan
authors.forename: Michael
authors.initials: M
authors.lastname: Alterman
authors.forename: Shlomo
authors.initials: S
authors.lastname: Kleinman
authors.forename: Vadim
authors.initials: V
authors.lastname: Reiser
authors.forename: Amir
authors.initials: A
authors.lastname: Shuster
authors.forename: Yaniv
authors.initials: Y
authors.lastname: Dagan
authors.forename: Benjamin
authors.initials: B
authors.lastname: Shlomi
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D012189:Retrospective Studies; D012797:Sialometaplasia, Necrotizing / Q000209:etiology / Q000473:pathology* / Q000628:therapy