necrotizing sialometaplasia of the larynx: a rare entity obscuring a malignancy

Introduction: necrotizing sialometaplasia is a rare, benign, and self-limiting inflammatory lesion that commonly involves minor salivary glands. it is theoretically associated with ischemia. it is commonly found in the palate, and laryngeal presentation is a very unusual entity. almost half of such cases have an underlying malignancy; therefore, suspicion of a malignant lesion should be high when this entity is found at any laryngeal level. case presentation: the present case was a 59-year-old male presenting a necrotizing sialometaplasia in the larynx, which obscured a malignancy, delaying the diagnosis until a positive metastatic cervical lymph node emerged. conclusion: necrotizing sialometaplasia is an extremely rare pathology at the larynx, with only five cases reported in the literature. the current case was the 6th to date. almost half of such cases presented a malignancy beneath the lesion; therefore, it is crucial to perform a close follow-up in such patients.