Oral Pyogenic Granuloma: Case Report of an Atypical Presentation

“Granulomas seem to be a defensive mechanism that triggers the body to “wall off” foreign invaders such as bacteria or fungi to keep them from spreading” [1]. Pyogenic granuloma is a relatively common benign skin growth that consists of vascular nodules of proliferating capillaries [2]. They grow rapidly and often occur following a minor injury or trauma, most likely as a vascular or fibrous response to injury or irritant [2]. Ultimately, the etiology of pyogenic granuloma is still unknown. Oral pyogenic granuloma is most commonly found on the gingiva, followed by the lips, tongue, buccal mucosa, and hard palate [3]. It often presents as a red, smooth, or lobulated exophytic lesion which can be pedunculated or sessile and often bleeds on provocation [4]. A microscopic evaluation of pyogenic granuloma often reveals that the lesion is fully or partially covered by parakeratotic or non-keratinized stratified squamous epithelium. The majority of the lesion is formed by a lobulated or non-lobulated mass of angiomatous tissue, with limited collagen present in the connective tissue of the lesion. The surface of the lesion may or may not be ulcerated but can be infiltrated by plasma cells, lymphocytes, and neutrophils [5]. Treatment of these lesions most often consists of surgical excision or curettage and electrodesication [2].