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References

Solomon LW, Merzianu M, Sullivan M, Rigual NR. Necrotizing sialometaplasia associated with bulimia: case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 103:39-42 https://doi.org/10.1016/j.tripleo.2006.08.005
Keogh PV, O'Regan E, Toner M, Flint S. Necrotizing sialometaplasia: an unusual bilateral presentation associated with antecedent anaesthesia and lack of response to intralesional steroids. Case report and review of the literature. Br Dent J. 2004; 196:79-81 https://doi.org/10.1038/sj.bdj.4810892
Muller S, Tilakaratne WM. Update from the 5th edition of the World Health Organization classification of head and neck tumours: tumours of the oral cavity and mobile tongue. Head Neck Pathol. 2022; 16:54-62 https://doi.org/10.1007/s12105-021-01402-9
Carlson DL. Necrotizing sialometaplasia: a practical approach to the diagnosis. Arch Pathol Lab Med. 2009; 133:692-698 https://doi.org/10.5858/133.5.692
Anneroth G, Hansen LS. Necrotizing sialometaplasia. The relationship of its pathogenesis to its clinical characteristics. Int J Oral Surg. 1982; 11:283-291 https://doi.org/10.1016/s0300-9785(82)80027-6

Letters to the editor

From Volume 50, Issue 7, July 2023 | Page 627

Authors

Sarah Fligelstone

Dental Core Trainee, Maxillofacial Unit, Swansea Bay University Health Board

Articles by Sarah Fligelstone

Article

We report the case of a 69-year-old women with necrotizing sialometaplasia, a condition caused by ischaemia and well recognized for mimicking squamous cell and/or muco-epidermoid carcinoma. An equivalent cutaneous example in its malignant resemblance is kerato-acanthoma. Both are self-limiting and monitored for resolution, whereas if cancerous, the most important prognostic factor is early intervention.1,2 Therein lies the consequence of diagnostic accuracy. This case discussion summarizes the learning necessary to support confident navigation by the general dental practitioner of this newly classified non-neoplastic lesion.3

The patient attended via the urgent suspected cancer route through her general medical practitioner. She complained of an 8-week history of sudden onset palatal discomfort that was consistent in nature. Soluble prednisolone, dispersible doxycycline, artificial saliva gel and benzydamine hydrochloride had all been used to treat the condition, but to no avail. She had an unremarkable medical history of long-standing stable comorbidities and had not smoked for 15 years (~25 pack-years).

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