[en] Introduction: Necrotizing sialometaplasia (NSM) is a benign lesion affecting the salivary glands mainly in the hard palate. It presents as an ulcer with irregular borders, slightly elevated and necrotic The differential diagnosis should include malignant neoplasms. Case Report: A 26-year-old woman sought medical advice for a painful 2 cm ulceration of the hard palate. She is carrying pierced tongue. The patient had a history of cigarette smoking, chronic anxiety disorder and bulimia,. Analytical normal (including HIV and syphilis serology). Histopathology: accessory gland with squamous metaplasia, pseudoepitheliomatous hyperplasia and conservation lobular architecture. She had an important improvement with total resolution of the lesion in 4 months Discussion: The NSM is a necrotizing inflammatory process. It presents as an ulcer located in the posterior hard palate or the junction between the hard and soft palate. This situation has been associated with local ischemia as surgical trauma, thromboangiitis obliterans, dentures, alcohol, snuff, cocaine, and certain malignancies such as lymphomas, rhabdomyosarcoma or Warthin tumor. Currently associated with bulimia, it being necessary suspected in young women. It is important to rule out neoplasms and infectious processes (tuberculosis or syphilis). Also consider subacute necrotizing sialadenitis, nonspecific acute inflammatory process of unknown cause, with focal necrosis without hyperplasia or ductal metaplasia pseudoepitheliomatous. Treatment is symptomatic and usually resolves in 2-3 months. Conclusion: The NSM is a benign lesion which may mimic neoplasia. The trend is toward resolution. It must be recognized to avoid unnecessary surgery.

[es] INTRODUCI?N: La sialometaplasia necrotizante (SMN), es una lesi?n benigna que afecta a las gl?ndulas salivares fundamentalmente en el paladar duro. Se presenta como una ?lcera de bordes irregulares, ligeramente elevados y lecho necr?tico El diagn?stico diferencial debe incluir neoplasias malignas. CASO CL?NICO: Mujer de 26 a?os de edad portadora de piercing en la lengua, fumadora con antecedentes de bulimia nerviosa. Presenta ?lcera de 2 cm en regi?n posterior del paladar duro de 2 meses de evoluci?n. Estudio anal?tico normal (incluida serolog?a VIH y s?filis). Estudio histopatol?gico: gl?ndula accesoria con metaplasia escamosa ductal, hiperplasia seudoepiteliomatosa y conservaci?n de la arquitectura lobular. Se resolvi? espont?neamente en 4 meses. DISCUSI?N: La SMN es un proceso inflamatorio necrotizante. Se presenta generalmente como una ?lcera localizada en la porci?n posterior del paladar duro o la uni?n entre el paladar blando y duro. Se ha asociado a situaciones de isquemia local como traumatismos quir?rgicos, tromboangeitis obliterante, pr?tesis dentales, alcohol, tabaco, consumo de coca?na, y ciertas neoplasias como linfomas, rabdomiosarcomas o tumor de Warthin. Actualmente se relaciona con la bulimia, debi?ndose sospechar en mujeres j?venes. Es importante descartar neoplasias y procesos infecciosos (tuberculosis o s?filis). Tambi?n se debe considerar la sialoadenitis necr?tica subaguda, proceso inflamatorio agudo inespec?fico de causa desconocida, con necrosis focal, sin metaplasia ductal ni hiperplasia seudoepiteliomatosa. El tratamiento es sintom?tico y generalmente se resuelve en 2- 3 meses. CONCLUSION: La SMN es una lesi?n benigna que puede simular una neoplasia. La evoluci?n es hacia la resoluci?n. Debe reconocerse para evitar cirug?as innecesarias.