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Clinical Note
October 2002

Submandibular Gland Squamous Metaplasia Mimicking Recurrent Squamous Cell Carcinoma: Diagnostic Dilemma

Author Affiliations

From the Departments of Head and Neck Surgery (Drs Babb, Rasgon, and Cruz) and Pathology (Dr Rumore), Kaiser Permanente Medical Center, Oakland, Calif.

Arch Otolaryngol Head Neck Surg. 2002;128(10):1201-1203. doi:10.1001/archotol.128.10.1201

New masses in the head and neck region of previously treated patients with cancer are considered suggestive of potential recurrence. Fine-needle aspiration is an excellent primary tool for evaluating these masses but may show atypical squamous cells that mislead clinicians to pursue aggressive treatment. We describe 3 patients in whom submandibular gland masses developed after radiation therapy for squamous cell carcinoma and for whom subsequent excisional biopsy findings showed benign squamous metaplasia. We review distinguishing clinical and histopathologic features that may allow these lesions to be identified. We also propose a treatment algorithm for this uncommon clinical scenario.

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