A 70-year-old male patient, smoker (15 sigarettes/die), presented with a ulceration of the left hard palate of four months duration, painful on the palpation (Fig. 1); anamnesis was uneventful (only arterial hypertension in therapy); no signs of bone involvement was detectable on panoramic radiograph (Fig. 2) and on CT scans; palpation of bilateral regional neck nodes was positive.

Clinical differential diagnosis included: traumatic ulcer; specific infective diseases (primary and secondary syphilis, primary and secondary tuberculosis); squamous cell carcinoma; malignant salivary tumours; major aphthous ulcer, non-Hodgkin’s lymphoma; Wegener’s granulomatosis; oro-facial granulomatosis; deep fungal infections; necrotizing sialometaplasia.