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Idiopathic huge pyogenic granuloma in young and old: An unusually large lesion in two cases.

Punde PA, Malik SA, Malik NA, Parkar M - J Oral Maxillofac Pathol (2013)

Bottom Line: In the first case, a 25-year-old young male patient and in the second case, 70-year-old female patient have been described.In both the cases, the size of lesion was more than 5 cm which has been rarely reported before.Also one of the cases describe here is of a postmenopausal female, which questions role of estrogen as an etiological factor.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Krishna Institute of Medical Sciences, Karad, Satara, Maharashtra, India.

ABSTRACT
Pyogenic granuloma (PG) is a reactive hyperplasia of connective tissue in response to local irritants, chronic irritation and hormonal changes. It is a tumor-like growth of the oral cavity frequently located in the region surrounding the anterior teeth or skin. It usually arises in response to various stimuli, such as low-grade local irritation, traumatic injury, hormonal factors or certain kinds of drugs. Clinically, the lesion appears as a smooth, lobulated, exophytic mass, exhibiting pink to reddish-purple color which can bleed on slight manipulation. PG has no malignant potential, but recurrence is common after surgical excision. Histologically, the surface epithelium may be intact and may show foci of ulcerations or exhibit hyperkeratosis. Gingiva is the most common site affected followed by buccal mucosa, tongue and lips. The size of lesion varies from millimeters to several centimeters; rarely exceeding 2-2.5 cm. PG larger than 2.5 cm are seldom reported. Estrogen has been considered as a major contributing factor in most of the cases. Thus, occurrence of PG is mostly seen in premenopausal age due to high levels of estrogen. In this article, two unusually large oral PG have been reported. In the first case, a 25-year-old young male patient and in the second case, 70-year-old female patient have been described. In both the cases, the size of lesion was more than 5 cm which has been rarely reported before. Also one of the cases describe here is of a postmenopausal female, which questions role of estrogen as an etiological factor.

No MeSH data available.


Related in: MedlinePlus

Case 2 - Excised specimen with teeth extracted
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Figure 6: Case 2 - Excised specimen with teeth extracted

Mentions: Surgical excision was planned for both the cases under general anesthesia, due to their extensive nature. After placement of Ryle's tube and nasal intubation, lignocaine 2% with 1:200,000 adrenaline was infiltrated at margins of the lesion. Pedunculated stalk was excised with help of a 15 no. B.P. blade and electrocautery. The mass, in both the cases, were extending interdentally. Thus, in order to avoid leaving any remnants of the lesion interdentally, the teeth involved were extracted and alveolar process trimmed. Hemostasis was achieved using electrocautery and Surgical. Primary closure was achieved. Antibiotics and analgesics were prescribed for 1 week. The excised tissue was sent for histological examination [Figures 5 and 6]. Patient was instructed to feed through Ryle's tube for 4 days. Wound healed without any complications. Patient was followed-up for 6 months, no recurrence was observed till date.


Idiopathic huge pyogenic granuloma in young and old: An unusually large lesion in two cases.

Punde PA, Malik SA, Malik NA, Parkar M - J Oral Maxillofac Pathol (2013)

Case 2 - Excised specimen with teeth extracted
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3927358&req=5

Figure 6: Case 2 - Excised specimen with teeth extracted
Mentions: Surgical excision was planned for both the cases under general anesthesia, due to their extensive nature. After placement of Ryle's tube and nasal intubation, lignocaine 2% with 1:200,000 adrenaline was infiltrated at margins of the lesion. Pedunculated stalk was excised with help of a 15 no. B.P. blade and electrocautery. The mass, in both the cases, were extending interdentally. Thus, in order to avoid leaving any remnants of the lesion interdentally, the teeth involved were extracted and alveolar process trimmed. Hemostasis was achieved using electrocautery and Surgical. Primary closure was achieved. Antibiotics and analgesics were prescribed for 1 week. The excised tissue was sent for histological examination [Figures 5 and 6]. Patient was instructed to feed through Ryle's tube for 4 days. Wound healed without any complications. Patient was followed-up for 6 months, no recurrence was observed till date.

Bottom Line: In the first case, a 25-year-old young male patient and in the second case, 70-year-old female patient have been described.In both the cases, the size of lesion was more than 5 cm which has been rarely reported before.Also one of the cases describe here is of a postmenopausal female, which questions role of estrogen as an etiological factor.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Krishna Institute of Medical Sciences, Karad, Satara, Maharashtra, India.

ABSTRACT
Pyogenic granuloma (PG) is a reactive hyperplasia of connective tissue in response to local irritants, chronic irritation and hormonal changes. It is a tumor-like growth of the oral cavity frequently located in the region surrounding the anterior teeth or skin. It usually arises in response to various stimuli, such as low-grade local irritation, traumatic injury, hormonal factors or certain kinds of drugs. Clinically, the lesion appears as a smooth, lobulated, exophytic mass, exhibiting pink to reddish-purple color which can bleed on slight manipulation. PG has no malignant potential, but recurrence is common after surgical excision. Histologically, the surface epithelium may be intact and may show foci of ulcerations or exhibit hyperkeratosis. Gingiva is the most common site affected followed by buccal mucosa, tongue and lips. The size of lesion varies from millimeters to several centimeters; rarely exceeding 2-2.5 cm. PG larger than 2.5 cm are seldom reported. Estrogen has been considered as a major contributing factor in most of the cases. Thus, occurrence of PG is mostly seen in premenopausal age due to high levels of estrogen. In this article, two unusually large oral PG have been reported. In the first case, a 25-year-old young male patient and in the second case, 70-year-old female patient have been described. In both the cases, the size of lesion was more than 5 cm which has been rarely reported before. Also one of the cases describe here is of a postmenopausal female, which questions role of estrogen as an etiological factor.

No MeSH data available.


Related in: MedlinePlus