Pedunculated eccrine poromas on non-acral sites.

A woman in her mid-50s, a patient with metastatic right breast carcinoma, postradical mastectomy and chemoradiation on hormonal therapy, presented with asymptomatic reddish lesions over the neck and trunk. Cutaneous examination revealed three discrete pedunculated, non-tender, firm erythematous growths with smooth surfaces over the neck, chest and abdomen. Histopathological examination was done with the differentials of pyogenic granuloma, haemangioma, giant acrochordon and vascular metastasis, revealing the diagnosis of eccrine poroma (EP). The remaining lesions were removed by electrocautery with no relapse till 1 year of follow-up. EP is a rare benign neoplasm arising from the acrosyringium that commonly presents as solitary, sessile or pedunculated asymptomatic papules or nodules over the palms and soles. Here we report the rare occurrence of multiple pedunculated EPs on a non-acral site in a patient who received chemoradiotherapy, which clinically mimicked pyogenic granuloma and vascular metastases. Thus, emphasising the importance of considering EP as a differential in lesions with vascular morphology.

Unusual clinical presentation, microscopy and immunohistochemistry of oral pyogenic granuloma in a paediatric patient.

An unusual clinical presentation of any pathology prompts a diagnostic dilemma, which further brings challenges in treatment planning. Pyogenic granuloma (microscopically lobular capillary haemangioma) is a benign vascular tumour that commonly involves the skin and mucous membranes and usually manifests as a solitary papule with a friable pedunculated base. Rapid exophytic growth and an ulcerated surface with bleeding on provocation are characteristic, with a gingival predominance for the site. This case report aims to elaborate on an unusual clinical presentation of oral pyogenic granuloma in a middle-childhood female patient. The clinical and radiographic characteristics of the lesion were unremarkable to the diagnosis but rather mimicked other intraoral lesions. It is histopathology that could solve the puzzle with the microscopic and immunohistochemical findings that rendered the final diagnosis of lobular capillary haemangioma.

Prevalence of Histopathologic Types of Gingival Lesions in the Iranian Population: A 22-Year Retrospective Study.

OBJECTIVES: Gingiva is one of the supporting tissues around the teeth that can be affected by various neoplastic or nonneoplastic lesions. Previous studies have examined several types of gingival lesions, but the lack of a standardized classification system has hindered meaningful comparisons. Additionally, many studies focused primarily on reactive lesions. Our study aims to contribute to the understanding of gingival lesions by investigating their prevalence across age groups, genders, sites, and by their clinical presentation. This research could lead to improved diagnostic accuracy and treatment strategies. MATERIALS AND METHODS: This retrospective study explores the prevalence of gingival lesions based on biopsies during a 22-year span. The patient's demographic details, including age, gender, and lesion's clinical presentation were systematically collected. These lesions were categorized into six groups. Descriptive statistics, χ2 test of independence, and one-way ANOVA were used for data analysis. RESULTS: Among the 7668 biopsied lesions, 684 (8.9%) lesions were located in the gingiva, with a greater occurrence in women (63.5%). Soft tissue tumors represented the most prevalent group in the gingival lesions (72.1%), and peripheral giant cell granuloma (PGCG) was the most frequent lesion (21.2%), followed by, pyogenic granuloma (19.3%), peripheral ossifying fibroma (17.8%) and focal fibrous hyperplasia (7.6%); all of which predominantly affected women, with mean ages falling in the fourth decade of life. Squamous cell carcinoma was recognized as the most common malignancy. CONCLUSION: In this study, PGCG was found to be the most common lesion in the gingiva in Iranian population. Further analysis using a unanimous categorization is required to confirm these results.

Pyogenes Granulom - Ein Fallbericht

A pyogenic granuloma is an acquired, benign tissue formation of the skin and/or oral mucosa. Surgical excision is the most common treatment for these lesions. In this case report a case of a 60-year-old woman with a pyogenic granuloma in region 21 is presented. An excisional biopsy was performed with a CO2 laser under local anesthesia and the specimen was examined by a pathologist. No recurrency were observed in this case.

Spontaneous eruptive disseminated lobular capillary haemangioma.

Lobular capillary haemangioma (LCH), previously known as pyogenic granuloma, is a benign vascular tumour of the skin or mucosa. We report a patient with spontaneous eruption of LCH, a rare occurrence, which resolved probably due to reverse koebnerisation.

[Pyogenic granuloma: a frequent and often misunderstood entity in primary care medicine]. / Botriomycome : une entité courante et souvent méconnue en médecine de premier recours.

Botriomycoma, also called pyogenic granuloma, is a common benign skin lesion that usually forms as a result of skin irritation. Although it is considered benign, its potential appearance as a malignant tumor can cause great concern in patients and lead to demand for prompt treatment. This article reviews the current knowledge about this lesion, including its possible causes, clinical manifestations, and treatment options.

Le botriomycome, aussi appelé granulome pyogénique, est une lésion cutanée bénigne courante qui se forme généralement à la suite d'une irritation de la peau. Bien qu'il soit considéré comme bénin, son apparence potentielle de tumeur maligne peut susciter une grande inquiétude chez les patients et entraîner une demande de traitement rapide. Cet article recense les connaissances actuelles sur cette lésion, y compris ses causes possibles, ses manifestations cliniques et les options de traitement.

Immunophenotypic profiles in chalazion and pyogenic granuloma associated with chalazion.

PURPOSE: To evaluate immunophenotypic profiles of infiltrating cells in surgically excised tissues of chalazion and pyogenic granuloma associated with chalazion. METHODS: Eighty-two surgical specimens from 74 consecutive patients newly diagnosed with chalazion or chalazion-associated pyogenic granuloma at Tokyo Medical University Hospital between 2016 and 2022 were studied. Sixty specimens were chalazion lesions and 22 specimens were pyogenic granuloma lesions (from 15 men and 7 women, mean age 36.6 ± 14.4 years). All patients were immunocompetent Asian Japanese adults. Specimens were analyzed by immunohistochemistry and flow cytometry. Flow cytometry was performed using the following antibodies: CD3, CD4, CD8, CD11b, CD11c, CD16, CD19, CD20, CD23, CD25, CD34, CD44, CD56, CD69, and CD138. RESULTS: In flow cytometric analysis, the proportion of cells expressing the T cell marker CD3 was significantly higher compared with other immune cells expressing specific markers (p < 0.0001), and the proportion of CD4-positive T cells was significantly higher than that of CD8-positive T cells (p < 0.0001), in both chalazion and pyogenic granuloma specimens. The chalazion and pyogenic granuloma lesions shared similar immunophenotypic profile characterized by predominant T cell infiltration, and CD4 T cells dominating over CD8 cells. The pattern of expression of CD4 and CD8 in the specimens was confirmed by immunohistochemistry. CONCLUSION: The present study demonstrates immunophenotypic features of chalazion and chalazion-associated pyogenic granuloma. Although various inflammatory cells are involved in the pathology of chalazion and pyogenic granuloma, a significantly higher proportion of CD4-positive T cells may be closely related to the pathological mechanisms of both lesions.

Benign Orofacial Vascular Anomalies: Review of 47 Cases in Enugu, Nigeria.

BACKGROUND: A study of oral vascular anomalies has not been conducted in Nigeria to provide baseline data for comparison with reports in the literature. AIMS: To study the prevalence and distribution of benign orofacial vascular anomalies at a tertiary hospital in Enugu. MATERIALS AND METHODS: This is a 10-year retrospective observational study of consecutive patients with orofacial vascular anomalies, diagnosed by histology. The clinic-pathologic information was obtained from records archived in the department, and descriptive analysis was used to determine the frequency, tables for categorical variables, and a Chi-square test to determine the statistical significance. RESULT: There were 47 cases of benign vascular anomalies out of 897 orofacial lesions giving a prevalence of 5.2%. There were 35.4% (17) male and 64.6% (31) female patients. The mean age in this series was 37.4 ± 19.8 (range: 1 to 76 years). Pyogenic granuloma was the most common vascular lesion 78.7% (37), followed by hemangioma 14.9% (7) and lymphangioma 6.4% (3). The gingiva was the most frequent site of oral occurrence 65.9% (31), especially maxillary gingivae 48.9% (23). The type of orofacial vascular anomalies was significantly associated with the anatomical site of occurrence, P = 0.00. The mean ages for the occurrence of pyogenic granuloma, hemangioma, and lymphangioma were 37.7 ± 18.3, 50.7 ± 16.9 years, and 3.3 ± 3.2 years, respectively. Pain was a frequent occurrence in 36.2% (17) of anomalies. CONCLUSION: Oral vascular anomalies predominantly presented as pyogenic granuloma on the gingivae, while oral hemangioma was observed in adults, and lymphangioma was infrequent.

Pigmented pyogenic granuloma of the cornea and conjunctiva: a rare bilateral presentation.

Pyogenic granuloma, also known as lobular capillary hemangioma, is a benign vascular lesion that primarily affects the skin and mucous membranes. It is not pyogenic; nor is it granulomatous. It typically arises in response to local trauma or surgery, irritation, hormonal changes, or chronic inflammation, and it sometimes occurs spontaneously. The occurrence of pigmented pyogenic granuloma in the conjunctiva and cornea without any history of trauma or surgery is extremely rare, particularly in children. We report the clinical presentation, diagnostic evaluation, and successful management of bilateral biopsy-proven conjunctival and corneal pigmented isolated pyogenic granuloma in an 11-year-old girl. No signs of recurrence were seen at the 3-months follow-up.

Capillary Haemangioma of Gingiva - A Rare Lesion.

Capillary Haemangioma is a benign vascular tumour characterized by proliferation of blood vessels with a very striking similarity to pyogenic granuloma with a predilection to occur on the gingiva. Though the head and neck are the most common region of occurrence, but is considered to be rare occurring on the gingiva, intra-orally. The lesion clinically mimicked pyogenic granuloma but was histopathologically diagnosed as capillary haemangioma. It was surgically excised and followed up for 6 months without any recurrence.

A Periodontal Perspective on the Successful Treatment of Recurrent Benign Gingival Lesions Affecting the Anterior Dentition: Two Case Reports.

Recurrent benign gingival lesions occurring in the anterior dentition are clinical dilemmas. While complete removal of such lesions is required to prevent recurrence, this can result in a poor esthetic outcome. Relative to this conundrum, this report discusses the diagnosis, psychologic management, and clinical treatment of two patients with recurring lesions on the facial gingiva of the mandibular and maxillary incisors, respectively. Patient A, a 55-year-old woman, presented with a recurrent peripheral ossifying fibroma (POF); Patient B, a 76-year-old man, presented with a recurrent pyogenic granuloma (PG). Both patients underwent multiple procedures and were ultimately treated without lesion recurrence. The efficacious surgical treatment of recurrent gingival lesions like POF and PG requires an aggressive approach involving lesion removal of the lesion as well as a 1.0- to 2.0-mm margin of normal tissue, underlying alveolar bone, and associated periodontal ligament (PDL). The rationale for this approach stresses the potential periodontal and esthetic ramifications that were considered. In summary, when recurrent benign gingival lesions are localized to the anterior part of the mouth, the approach to their surgical removal should be modified to minimize the extent of gingival recession and other potential esthetic issues.

Angioleiomioma oral mimetizando um granuloma piogênico: relato de caso raro / Oral Angioleiomyoma mimetizing a pyogenic granuloma: A rare case report

Angioleiomioma (AL) é um tumor benigno de origem perivascular que raramente é observado na cavidade oral, principalmente em localizações como a gengiva. Devido sua apresentação clínica inespecífica, os ALs podem mimetizar outras lesões orais, como tumores benignos de glândulas salivares e lesões reacionais, como o granuloma piogênico. O presente artigo objetiva relatar um caso raro de AL localizado em gengiva, em uma paciente de 19 anos. Clinicamente, a lesão apresentava-se como um tumor assintomático, oval, pedunculado, bem definido, com superfície lisa, consistência fibrosa e cor eritematosa, semelhante a um granuloma piogênico, Uma biópsia excisional foi realizada e o fragmento foi encaminhado para análise histopatológica, que revelou uma proliferação vascular de diversos calibres, contendo paredes musculares espessas e proliferação muscular adjacente, além de infiltrado inflamatório, predominantemente crônico, hemácias extravasadas e área de ulceração, consistente com o diagnóstico de AL inflamado. A histopatologia desempenha um papel importante no diagnóstico final de lesões raras e com características clínicas inespecíficas. A excisão cirúrgica da lesão é o tratamento de escolha mais eficaz para os ALs orais. (AU)

Angioleiomyoma (AL) is a benign tumor of smooth muscle of perivascular origin that is rarely seen in the oral cavity, mainly in locations like the gingiva. Due to their nonspecific clinical presentation, ALs can mimic other oral lesions, such as benign salivary gland tumors and reactional lesions, as a pyogenic granuloma. We reported a case of an AL located in the gingiva in a 19-year-old female patient. In clinical terms, the lesion was presented as an asymptomatic, oval, pedunculated, well-defined nodule with a smooth surface, fibrous consistency and erythematous color, similar to a pyogenic granuloma. An excisional biopsy was performed and the fragment was sent for histopathological analysis that revealed a vascular proliferation of different calibers, containing thick muscle walls and adjacent muscle proliferation, in addition to an inflammatory infiltrate, predominantly chronic, extravasated red blood cells and an area of ulceration, consistent with the diagnosis of inflamed AL. The histopathology plays an important role in the final diagnosis of rare lesions and with nonspecific clinical characteristics. The surgical excision of the lesion is the most effective treatment of choice for oral ALs. (AU)

Lobular capillary hemangioma (pyogenic granuloma) of the gastrointestinal tract: Clinicopathologic analysis of 34 cases.

OBJECTIVES: Lobular capillary hemangioma (LCH) rarely involves the gastrointestinal (GI) tract. This study describes clinicopathologic features of LCH in a cohort of GI cases. METHODS: We defined lobular capillary hemangioma as "a proliferation of capillary-sized blood vessels arranged at least focally in a lobular configuration," searched departmental archives for cases, and recorded clinicopathologic findings. RESULTS: We identified 34 GI tract LCHs from 16 men and 10 women; 4 patients had multiple lesions. Mean age was 64 years. Cases arose in the esophagus (n = 7), stomach (n = 3), small bowel (n = 7), and colorectum (n = 17). Twelve patients had anemia or rectal bleeding. No patients had a known genetic syndrome. The lesions manifested as mucosal polyps, with median size of 1.3 cm. Microscopically, 20 lesions were ulcerated, and most involved the mucosa, with 9 extending into the submucosa. Vessel dilation was present in 27 patients, endothelial hobnailing in 13, hemorrhage in 13, and focal reactive stromal atypia in 2. Follow-up information was available for 10 patients, none of whom developed same-site recurrence. Six of the 26 cases (23%) were extradepartmental consultations, including 2 of the multifocal cases. CONCLUSIONS: Gastrointestinal tract LCHs often arise as colorectal polyps. They are typically small but can reach a few centimeters in size and can be multifocal.

Rare airway tumor in a previously healthy adolescent successfully treated with endoscopic resection and oral propranolol.

Airway tumors are rare in children. Pyogenic granuloma (PG), also known as lobular capillary hemangioma, is a benign vascular tumor usually found on the skin or in the oral cavity. Rarely, these lesions occur in the airway and cause significant hemoptysis. Most reported airway PGs have occurred in the trachea of adults. Here, we present a case of an adolescent female who presented with hemoptysis and was found to have a PG in the right lower lobe. Per institutional guidelines, this case report was exempt from institutional review board approval.

A large-cohort study of 2971 cases of epulis: focusing on risk factors associated with recurrence.

BACKGROUND: To analyze the clinicopathological features of different histological subtypes of epulis, and evaluate the risk factors associated with recurrence. MATERIALS AND METHODS: A retrospective study including 2971 patients was performed. The patients' sex, age, location, size, histological subtypes, recurrence information, oral hygiene habits, periodontitis symptoms and smoking history were retrieved from the patient medical records and follow-up information. RESULTS: Among the 2971 cases, focal fibrous hyperplasia (FFH) was the most common lesion (60.92%), followed by peripheral ossifying fibroma (POF) (29.32%), pyogenic granuloma (PG) (8.08%) and peripheral giant cell granuloma (PGCG) (1.68%). The peak incidence of epulis was in the third and fourth decade of life, with a mean age of 45.55 years. Female predominance was found in all types of lesions with a female to male ratio of 1.71:1. PG had the highest recurrence rate (17.18%), followed by POF (12.98%), FFH (9.55%) and PGCG (8.82%). Histological subtypes were significantly correlated with the recurrence of epulis (P = 0.013). Regular supportive periodontal therapy (P = 0.050) had a negative correlation with recurrence, whereas symptoms of periodontitis (P < 0.001) had a positive correlation with the recurrence of epulis. CONCLUSIONS: Controlling the periodontal inflammation and regular supportive periodontal therapy might help reduce the recurrence of epulis.

Intraoral healing type of pyogenic granuloma (A benign vascular tumor): A case report.

Pyogenic granulomas represent tumor-like lesions affecting the skin and the oral cavity. This classic definition can be somewhat misleading because such lesion is not associated with infection and lacks any clinical evidence of pus or histological evidence of actual granulation tissue. This case report describes a surgical excision of the growth to exclude angiomatous proliferation. The patient reported a chief complaint of localized gingival overgrowth since 4 months. Intraoral examination revealed an irregular, sessile exuberant growth in respect to labial aspect and interdental gingiva of 31, 32, and 33, measuring about 1.6 × 1.1 cm. Based on the clinical findings, the case was provisionally diagnosed as "pyogenic granuloma". A treatment was planned for the patient. A surgical excision was done irt 31, 32, 33, and the tissue was sent for histopathological examination, which was suggestive of a healing type of pyogenic granuloma.

Treatment of a Large Nail-Bed Pyogenic Granuloma with Topical Timolol.

Nail pyogenic granulomas are common benign vascular lesions often occurring after trauma. A variety of treatment modalities exist, including topical therapies and surgical excision, although both have their pros and cons. In this communication, we describe the case of a 7-year-old boy with repeated toe trauma, who developed a large nail bed pyogenic granuloma after undergoing surgical debridement and nail bed repair. He was treated with 3 months of topical 0.5% timolol maleate, resulting in complete resolution of the pyogenic granuloma and minimal nail deformity.