Department of Oral and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Nov;114(5):577-85. doi: 10.1016/j.oooo.2012.02.020. Epub 2012 Aug 22.
The aim of this report was the clinical and histologic characterization of necrotizing sialometaplasia.
We performed a retrospective case series analysis.
The study included 4 women 29-71 years old. Possible contributing factors (drugs, alcohol abuse, bulimia, smoking, and pancreatic cancer) were identified. Patients presented with unilateral or bilateral rapidly progressing painful palatal ulcers. Necrotic salivary glands and inflammation were universal microscopic features; ductal metaplasia was present in only 1 case. Thrombosis and heavy fungal and bacterial overgrowth were observed in 1 case. In 3 of the cases the lesions healed within 4-6 weeks under conservative supportive care, whereas in 1 case persistent enlargement up to 25 mm diameter was observed. Surgical debridement combined with a palatal guard resulted in complete healing within 12 weeks.
Significant variations may be observed in both clinical and microscopic manifestations of necrotizing sialometaplasia. Although this disease is considered to be self-limiting in the majority of cases, surgical intervention can be considered in unusually large cases.
本报告旨在对坏死性涎腺化生进行临床和组织学特征分析。
我们进行了回顾性病例系列分析。
研究纳入 4 名女性，年龄 29-71 岁。确定了可能的致病因素（药物、酗酒、贪食、吸烟和胰腺癌）。患者表现为单侧或双侧快速进展的疼痛性腭部溃疡。坏死的唾液腺和炎症是普遍的显微镜特征；仅 1 例存在导管化生。1 例观察到血栓形成和严重的真菌和细菌过度生长。3 例患者在 4-6 周的保守支持治疗下病变愈合，而 1 例患者持续增大至 25mm 直径。手术清创联合腭护板治疗后，12 周内完全愈合。
坏死性涎腺化生的临床表现和组织学表现可能存在显著差异。尽管大多数情况下该病具有自限性，但在异常大的病例中可以考虑手术干预。
