[Necrotizing sialometaplasia--a specific differential diagnosis of an ulcer of the hard palate].

BACKGROUND

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.

PATIENTS: 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.

CONCLUSIONS

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.