A case report of necrotizing sialometaplasia with immunohistological findings and a review of the literature

Abstract

We report a case of necrotizing sialometaplasia arising as bilateral ulcers in the palate of a 20-year-old Japanese female patient. Based on histopathological and immunohistochemical findings, we discuss how to distinguish the condition from neoplastic lesions such as squamous cell carcinoma or mucoepidermoid carcinoma. Histopathologically, the ulcer bed of granulation tissue contained hyperplastic capillary vessels, inflammatory cell infiltrates, necrotizing and degenerating palatal glands, and squamous metaplasia of ducts and acini leaving lobular structures of the mucous gland. Immunohistochemically, the epithelial islands were positive for pancytokeratin (CK), CK7 and S-100 protein, partially positive for α-smooth muscle actin, and not positive for periodic acid-Schiff reaction. We diagnosed the lesion as a necrotizing sialometaplasia. It healed spontaneously without treatment, and there was no recurrence.