This is a necrotizing sialométaplasie.
Described for the first time by Abrams et al. in 1973, this
lesion, relatively rare, is an inflammatory ulceration
non-neoplastic salivary glands [1]. It
represents approximately 0.03% of lesions diagnosed by
biopsy [2].
This lesion almost exclusively palate was nevertheless
observed in other locations: retromolar regions and
lingual, nasal cavity, maxillary sinus, salivary gland
major (submandibular, parotid and sublingual) [1-4].
The lesion begins with a painful focal swelling.
After a few days, it gives way to an ulcer edge
net, which can extend to the bone, surrounded by a halo
erythematosus [2]. Once the ulcer is installed, it causes
little pain [5].
If the pathogenesis is poorly understood, some authors suggest
reached a physical-chemical blood vessels
would be responsible for disturbances in ischemic
salivary glands leading to their infarction [1].
The causative factors are mentioned multiple intubations
difficult, local anesthesia, ill-fitting dentures,
repetitive violent vomiting (encountered in cases
anorexia / bulimia), local infections, smoking, radiation
or taking cocaine [1-4]. Diabetes and
chronic alcoholism is an encouraging field [1].
From the perspective of pathological, ulceration contains
granulation tissue non-specific, there is a salivary lobules nécrosedes ischemic periphery, a
neovascularization and squamous metaplasia of the canaliculi
and mucous acini in the center of the lesion [2]. Unlike
the salivary carcinomas, lobular architecture keeps
its integrity in the necrotizing sialométaplasie [1].
Histopathologic examination performed on the biopsy
confirmed in our patient the diagnosis of sialométaplasie
necrotizing.
Healing is usually spontaneous and occurs in 7 to
10 weeks, usually leaving a scar. This was
the case in our patient.
The clinical and histological similarities with neoplasia
Oral (carcinomas), stress the importance of diagnosis
accurate and early to avoid possible treatments
unnecessarily mutilating.
إذا رأيت شخصاً يسامحك گثيرا ,,فأعلـــم:
أنه يحترمك لـدرجة كبيرة ولا يريد أن يخسرك,فلا تتمادى في أخطاءك.