DOI: https://doi.org/10.36347/sjmcr.2026.v14i07.010

Pages: 1651-1654

Background: Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor in both adults and children. Necrotizing sialometaplasia (NS) is a benign, self-limiting inflammatory lesion that is classically recognized as a histological mimic of MEC. However, its occurrence in a resection specimen following a biopsy-proven MEC represents an unusual diagnostic challenge. Case presentation: We report the case of a 15-year-old adolescent presenting with a palatal low-grade mucoepidermoid carcinoma diagnosed on incisional biopsy. Surgical excision was performed four weeks later. Histopathological examination of the entirely submitted resection specimen revealed no residual carcinoma but showed only post-biopsy changes associated with foci of necrotizing sialometaplasia. Discussion: Unlike the classical diagnostic pitfall in which necrotizing sialometaplasia mimics mucoepidermoid carcinoma, this case illustrates the opposite situation. The absence of residual tumor associated with post-biopsy necrotizing sialometaplasia may cast doubt on a previously established diagnosis of malignancy, emphasizing the importance of correlating biopsy findings with the surgical specimen. Conclusion: This report highlights an uncommon clinicopathological scenario in which post-biopsy necrotizing sialometaplasia may lead to an apparent discrepancy between the biopsy and the resection specimen. Careful histopathological review and clinicopathological correlation are essential to avoid diagnostic misinterpretation.