Necrotizing sialometaplasia of the parotid gland associated with facial nerve paralysis.
BACKGROUND
Necrotizing sialometaplasia is a benign inflammatory lesion involving most frequently the minor salivary gland of the hard palate. Involvement of the parotid gland is rare, involvement of the parotid gland associated with facial palsy is exceptional.


METHODS
A 56-year-old male patient with Marfan syndrome presented with swelling and inflammation of the left parotid gland associated with progressively complete facial nerve paralysis. CT scan and MRI showed a parotid collection with hyper signal of the nearest tissues associated with erosion of the styloid process. A malignant tumor was suspected. The histological examination of a biopsy showed a lobulocentric process with necrosis, squamous metaplasia, and inflammation. The immunohistochemical examination supported a final diagnosis of necrotizing sialometaplasia.


CONCLUSIONS
Necrotizing sialometaplasia of the parotid gland associated with facial nerve paralysis presents like a malignant neoplasm, both clinically and histologically. Only advanced immunohistochemical examination can really confirm the diagnosis.
Service de stomatologie et chirurgie maxillofaciale, hôpital d'instruction des armées Laveran, BP 60149, 13384 Marseille cedex 1, France; Service de stomatologie et chirurgie maxillofaciale, DHU FAST, groupe hospitalier Pitié-Salpêtrière Charles-Foix, AP-HP, 75013 Paris, France. Electronic address: pierre.haen@yahoo.fr.
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Haen
Service de stomatologie et chirurgie maxillofaciale, DHU FAST, groupe hospitalier Pitié-Salpêtrière Charles-Foix, AP-HP, 75013 Paris, France; UMR 8256 B2A, Sorbonne universités, UPMC université Paris 6, 75005 Paris, France.
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Ben Slama
Service de stomatologie et chirurgie maxillofaciale, DHU FAST, groupe hospitalier Pitié-Salpêtrière Charles-Foix, AP-HP, 75013 Paris, France; UMR 8256 B2A, Sorbonne universités, UPMC université Paris 6, 75005 Paris, France.
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Goudot
Service de stomatologie et chirurgie maxillofaciale, DHU FAST, groupe hospitalier Pitié-Salpêtrière Charles-Foix, AP-HP, 75013 Paris, France.
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Schouman
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005154:Facial Nerve / Q000473:pathology*; D005158:Facial Paralysis / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010305:Parotid Diseases / Q000175:diagnosis / Q000209:etiology*; D011239:Prednisolone / Q000627:therapeutic use; D012797:Sialometaplasia, Necrotizing / Q000175:diagnosis / Q000209:etiology*
D000900:Anti-Bacterial Agents; D011239:Prednisolone
Facial palsy; Necrotizing sialometaplasia; Parotid gland