Necrotizing Sialometaplasia
Good evening!
I have a growth on my nasal septum. Frozen biopsy during surgery came back as squamous cell carcinoma. Surgeon was surprised so sent different frozen samples that came back as necrotizing sialometaplasia. Plan was to wait for final path report, that arrived today. Pathologist said most cells are consistent with NS but SCC cannot be ruled out so further clinical evaluation is needed. I talked to doctor today and he’s certain it’s NS. He said no treatment is necessary, we just keep an eye on it as NS heals within 2-12 weeks. We first saw it with the scope in March which he said at that time was just inflammation. September 7th follow up scope showed significant changes to that area as well as the right sphenoid. Surgery on 9/23 right sphenoid sinus blockage removed: polyps and other necrotizing tissue. Frozen and final path shows no malignancy. Frozen biopsy from L septum and turb showed SCC and also NS. Final lab report suggests NS but “can’t rule out carcinoma” as abnormal cells are present. Doctor says NS is very rare, especially in the nasal cavity. He said surgery to remove it is very risky given the location. It doesn’t sound like he will remove it without a confirmed cancer dx. I’m not comfortable with the let’s watch it and see approach and am worried about having abnormal cells that close to my eye and brain. Even if it’s NS, any type of metaplasia has the potential of turning into cancer so I’m concerned. Have any of you experienced something like this? I plan to get a second opinion. I work at the hospital, doctors I work with (not ENT) think it needs to be removed. I’m having a hard time finding literature on NS in the nasal cavity so just looking for anyone that has maybe seen, heard of, or experienced it. Thanks in advance for any information. I’ve filled out the form for a consult at the MN location.
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Hello @annie1979, I had not heard of Necrotizing Sialometaplasia (NS) and your posts were the only ones I could find searching Connect. I did find some articles on NS that might be helpful if you have not already seen them.
-- 2014 - Necrotizing sialometaplasia: A diagnostic dilemma!:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4409189/
-- 2020 - Necrotizing sialometaplasia: a malignant masquerade but questionable precancerous lesion, report of four cases:
https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-020-01189-1
-- 2022 - A diagnostic error of a necrotizing sialometaplasia: Case report:
https://www.sciencedirect.com/science/article/pii/S2049080121011754
A good search engine to use for finding medical research papers is Google Scholar. Here is a link for the search results for "necrotizing sialometaplasia treatment" sorted by the year 2022 so you see the newest articles:
https://scholar.google.com/scholar?as_ylo=2022&q=necrotizing+sialometaplasia+treatment&hl=en&as_sdt=0,24
I'm happy to hear you have a consult scheduled at Rochester Mayo Clinic. How soon is your consult?
Thank you for the information! I have been reading article after article and they are all helpful. I am waiting to hear back regarding an appointment.
Any update on your final pathologist report? I’ve got NS on Septum too, not going away after 6 months only diagnosed in June. Stanford is looking at tissue to confirm but I’m not optimistic this is NS. Any update is appreciated
Tbc0057
Checking in again for an update on Annie's diagnosis. I'm still waiting for a pathology report. Wondering what's happened in Annie's case.