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Article: Volume 49 Number 2 Page 141 - February 2022

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  Dental Update 497: 141-143

Oral medicine:  Necrotizing sialometaplasia

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Abstract: In this case of a 45-year-old woman, who attended the primary care service at Birmingham Dental Hospital with widespread ulceration affecting the hard palate, histopathological, haematological and immunological testing confirmed a diagnosis of necrotizing sialometaplasia (NS), a rare benign minor salivary gland condition. The aetiology of NS is unknown; however, it is thought to represent necrosis of the mucoserous acini due to ischaemia. The clinical features of NS are similar to of squamous cell carcinoma and histopathological investigations may be required to exclude malignancy.

Clinical relevance: The article highlights the importance of recognizing necrotizing sialometaplasia to prevent misdiagnosis and ensure correct management is undertaken.

Author notes: Monica Patel, BDS, MFDS RCPSG, Dental Core Trainee in Restorative Dentistry, University College London, Eastman Dental Hospital, University College London NHS Foundation Trust. K Cullotty, BDS, FDS RCPS(Glasgow), Service Lead: Primary Unscheduled Care, Birmingham Dental Hospital, Birmingham Community Healthcare NHS Foundation Trust. A Richards, BDS, MSc Lond, FDS RCS Oral Medicine (Eng), Consultant/Honorary Senior Lecturer in Oral Medicine, Birmingham Dental Hospital, Birmingham Community Healthcare NHS Foundation Trust. email: monica.patel8@nhs.net

Objective: To understand the presentation of necrotizing sialometaplasia and what investigations are required to confirm its diagnosis.