Persistent ulceration of the oral floor: a case of necrotizing sialometaplasia of the sublingual gland?

Cédric Alande,Jean-Christophe Fricain,Mathilde Fénélon,Sylvain Catros

doi:10.1051/mbcb/2017019

Cédric Alande, Jean-Christophe Fricain + Show 2 more

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https://doi.org/10.1051/mbcb/2017019

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Journal: Médecine Buccale Chirurgie Buccale	Publication Date: Nov 1, 2017
Citations: 1	License type: cc-by

Affiliation: Hôpital Pellegrin

Abstract

Introduction: Necrotizing sialometaplasia is an inflammatory, rare and benign pathology, affecting particularly minor salivary glands. Observations: A case of deep and persistent ulceration of the oral floor associated with sensitivity disorders is reported. Three biopsies were realized, each concluding to a nonspecific ulceration. Local treatments by triamcinolone injections and laser CO 2 were tested. After 18 months of follow-up, a partial regression of the lesion was observed and the patient did not have any sensitivity disorders. Comments: This ulceration was clinically evocative of malignant neoplasia, which was reversed by histology. Others causes of ulceration were excluded on clinical and biological arguments. By elimination, a diagnosis of necrotizing sialometaplasia of the sublingual gland was made. Conclusion: Only one case of necrotizing sialometaplasia of sublingual gland has already been published. The case described here is exceptional due to the low prevalence of the lesion and the chronic ulcer evolution.

Highlights

In October 2015, a 29-year-old patient consulted the oral surgery department for a deep ulcer on the floor of the mouth that had developed over 4 months
The diagnosis of the case reported here is of particular interest, because of the chronic nature of the ulceration
The clinical and histological aspect of necrotizing sialometaplasia (NS) can often be misdiagnosed as a carcinogenic lesion, which can sometimes lead to unnecessary surgical intervention [4]

Summary

Introduction

Described for the first time in 1973 by Abrams et al, NS is a benign inflammatory pathology of the salivary glands, whose etiopathogenesis is still poorly defined [1,2]. Rare cases of NS of the salivary glands have been reported, one of which can affect the sublingual gland [3]. The diagnosis of the case reported here is of particular interest, because of the chronic nature of the ulceration. This case was a severe example and could be potentially misdiagnosed as malignant neoplasia.

Results

Conclusion