Palatal Nodule in Bulimia Patient: An Early Sign of Necrotizing Sialometaplasia.

Necrotizing sialometaplasia (NS) is a rare inflammatory condition. Despite rare, chronic self-induced vomiting in patients with eating disorders has been reported as a risk factor. This study aims to report a case of NS in a patient with bulimia nervosa and review the literature. A 25-year-old woman presented with a crateriform painful ulcer, affecting the palatal mucosa, measuring 3 cm in its largest extension. The main diagnosis hypothesis was NS. On the third visit, the patient mentioned suffering bulimia with episodes of self-induced vomiting. Consequently, the diagnosis was NS associated to bulimia was performed. Ulcer regression was observed after 4 weeks without any specific treatment. A literature search was performed in MEDLINE/PubMed, Scopus, and Embase and resulted in 12 case reports of NS in patients with eating disorders. Including our case, 12 out of 13 patients were women with a mean age of 23 years. This case reinforces the association between NS and eating disorders, particularly bulimia nervosa. Its accurate diagnosis is crucial to avoid misinterpretation as malignancy, thereby preventing unnecessary invasive interventions.