Koscielny S, Raabe G
HNO-Klinik, Institut für Pathologie, Friedrich-Schiller-Universität Jena.
Laryngorhinootologie. 2003 Aug;82(8):568-72. doi: 10.1055/s-2003-41237.
Ulcers of the hard palate are mostly caused by malignancies. In addition, rare diseases should be included in the differential diagnosis. Beside specific inflammations (lues, tuberculosis) necrotizing sialometaplasia belongs to these uncommon medical conditions.
A 51-year-old male was admitted to the hospital with an algetic ulcer of the hard palate. Malignancy was ruled out by pathohistological examination. Inflammation or infection was excluded by serological examination. A second biopsy was investigated by the pathologist suspecting necrotizing sialometaplasia and confirmed the suspicion. By applying local treatment and systemic antibiosis against bacterial superinfection the ulcer finally healed.
Necrotizing sialometaplasia is a rare medical condition generated by local circulatory disorder. 128 cases were published so far. Typical patients are males aged 50 and above. Characteristics of this ulcer are a high rate of spontaneous healing and lacking malignancy. After excluding a malignant tumor this rare disease has to be considered when diagnosing an ulcer of the hard palate.
硬腭溃疡大多由恶性肿瘤引起。此外，鉴别诊断还应包括罕见疾病。除了特定炎症（梅毒、结核）外，坏死性涎腺化生属于这些罕见病症。
一名51岁男性因硬腭疼痛性溃疡入院。病理组织学检查排除了恶性肿瘤。血清学检查排除了炎症或感染。病理学家对第二次活检进行检查，怀疑为坏死性涎腺化生并证实了这一怀疑。通过局部治疗和针对细菌二重感染的全身抗生素治疗，溃疡最终愈合。
坏死性涎腺化生是一种由局部循环障碍引起的罕见病症。迄今为止已发表128例病例。典型患者为50岁及以上男性。这种溃疡的特点是自发愈合率高且无恶性病变。在排除恶性肿瘤后，诊断硬腭溃疡时必须考虑这种罕见疾病。
