Head and neck tumours: necrotising sialometaplasia: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Head and neck tumours: necrotising sialometaplasia

Sample item

A smoker presents with a deep crater-like ulcer on the hard palate that appeared rapidly after dental local anaesthetic injection. Biopsy shows lobular necrosis of minor salivary glands with squamous metaplasia of the ducts. How should it be managed?

ARadiotherapyBLong-term systemic antifungal therapyCWide excision with neck dissectionDReassurance, as it heals spontaneously over weeks

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Reassurance, as it heals spontaneously over weeks

Necrotising sialometaplasia is a benign, self-limiting ischaemic lesion of minor salivary glands, usually on the hard palate. Its pseudo-epitheliomatous hyperplasia can be mistaken histologically for squamous carcinoma, so awareness avoids overtreatment. It heals by secondary intention in about 6 to 10 weeks.

Option by option

A. Radiotherapy
Radiotherapy is not indicated for a benign self-healing lesion.
B. Long-term systemic antifungal therapy
It is not a fungal infection, so antifungals do not help.
C. Wide excision with neck dissection
Radical surgery is for malignancy and would be an overtreatment.
D. Reassurance, as it heals spontaneously over weeks (correct)
Correct. Once diagnosed it needs only observation and analgesia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, Reassurance, as it heals spontaneously over weeks. Necrotising sialometaplasia is a benign, self-limiting ischaemic lesion of minor salivary glands, usually on the hard palate.

Why is "Radiotherapy" not the answer?

Radiotherapy is not indicated for a benign self-healing lesion.

Why is "Long-term systemic antifungal therapy" not the answer?

It is not a fungal infection, so antifungals do not help.

Why is "Wide excision with neck dissection" not the answer?

Radical surgery is for malignancy and would be an overtreatment.

What concept does this question test?

It tests Head and neck tumours: necrotising sialometaplasia in ENT. Its pseudo-epitheliomatous hyperplasia can be mistaken histologically for squamous carcinoma, so awareness avoids overtreatment. It heals by secondary intention in about 6 to 10 weeks.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Head and neck tumours: necrotising sialometaplasia?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.