DIFFERENTIAL DIAGNOSIS, INVESTIGATIONS AND TREATMENT
A provisional diagnosis of malignant ulcer was given, and the
differential diagnosis with necrotizing sialometaplasia was considered.
The occlusal radiograph depicted normal bone architecture., Laboratory
investigations were within normal limits. The patient was subjected to
incisional biopsy using infiltration anesthesia. The histopathological
examination revealed Fibrinoid necrosis with sheet of neutrophils
(figure 2) and Few acini surrounded by dense neutrophilic infiltration
are present in the left upper corner, Hyperplastic squamous epithelial
lining present on the right lower corner (figure 3). The final diagnosis
of necrotizing metaplasia was arrived at based on clinical examination
and histopathological analysis. The patient was subjected to symptomatic
treatment, debridement of lesion using normal saline was made. The
patient was assured of the lesion being of benign nature and as tobacco
being one of the causes, tobacco cessation counselling was also done.