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 . It
represents approximately 0.03% of lesions diagnosed by
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 . Once the ulcer is installed, it causes
little pain .
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 .
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 .
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 . Unlike
the salivary carcinomas, lobular architecture keeps
its integrity in the necrotizing sialométaplasie .
Histopathologic examination performed on the biopsy
confirmed in our patient the diagnosis of sialométaplasie
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