Nodular and ulcerated lesions of the hard palate

Necrotizing sialometaplasia cannot be diagnosed clinically and has frequently been misdiagnosed microscopically. The fact that the disease can be misinterpreted as cancer is sufficient cause for the clinician to question a malignant diagnosis of an ulcerated or nodular lesion, especially one of the hard palate, that developed rather rapidly. When performing a biopsy of these lesions, care should be taken to ensure adequate size and depth of the specimen, as small biopsy tissue samples might include only the necrotic and actively regenerating portions of the lesion, thus causing diagnostic problems. Necrotizing sialometaplasia certainly should be considered in a differential diagnosis of soft tissue lesions arising in the vicinity of intraoral minor salivary glands, especially on the hard palate.