Multifocal Necrotizing Sialometaplasia in the Tongue Surgical Specimen: An Immunohistochemical Study

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Abstract
Background Necrotizing sialometaplasia (NSM) is a rare self-limiting inflammatory lesion, with most cases affecting the minor salivary glands, especially those located in the palate (70%). To date, about 261 cases of NSM have been reported. Of them, 7 cases affected the tongue; 37 cases occurred after surgery; and 17 cases showed association with neoplasms. Methods A 50-year-old male patient was diagnosed with squamous cell carcinoma (SCC) of the tongue. After surgical excision, the tumor diagnosis was well-differentiated SCC with a close surgical margin. Re-excision of the margin was indicated. Results Microscopically, the surgical margin showed neither residual SCC nor epithelial dysplasia. However, it was possible to observe 7 foci containing typical areas of NSM distributed throughout the surgical specimen, which, by immunohistochemistry, revealed a glandular nature with presence of myoepithelial cells. Conclusion We present here an unusual multifocal NSM affecting the tongue at the site of a prior resection for SCC with close margins, which, to the best of our knowledge, has not been reported to date.
Funding Information
  • Fundação de Amparo à Pesquisa do Estado de São Paulo (2016/11419-0; 2022/07479-9 and 2022/12760-9)
  • Conselho Nacional de Desenvolvimento Científico e Tecnológico (304241/2021-0)
  • Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (001)