Uncommon location of pyogenic granuloma in a child – case report and mini-review

ABSTRACT

Introduction. Pyogenic granuloma (PG) is a vascular inflammatory hyperplasia involving the skin and oral mucosa, often associated with local irritation or trauma, or with pregnancy. Intraoral location usually affects the gingiva, but tumoral aspect can be misleading, especially in extra-gingival locations. A thorough assessment and diagnosis are therefore important for ensuring the proper treatment.

Case presentation. We report the case of a 12-year-old boy who presented for a growing and bleeding tumour of his lower lip mucosa. The tumour was labeled as “hemangioma”. It was growing for several weeks and associated with minor, but repeated mucosal trauma. Although the anatomic location was not common, the patient history suggested a diagnosis of PG. After a dermatologic assessment, which proposed a differential diagnosis with oral papilloma, a soft tissue ultrasound sustained the clinical diagnosis. The tumour was surgically excised and the defect was closed directly with absorbable sutures. Three weeks later the mucosa had a healthy appearance, without signs of impaired healing or tumour recurrence. The histopathological exam confirmed the clinical diagnosis.

Conclusions. There are several types of soft tissue solid or vascular tumours that can be mislabeled and the diagnosis of hemangioma is commonly used for various vascular anomalies. In our case, the clinical aspect, together with the tumoral growing pattern and the history of repeated trauma, led us to the correct diagnosis and treatment. Surgical excision completely removes the PG and ensures rapid and esthetically convenient healing, without complication or tumour regrowth.

Keywords: pyogenic granuloma, children, oral mucosa, lower lip, surgical excision.

Address for correspondence:
Raluca T. TATAR
“Grigore Alexandrescu” Clinical Emergency Hospital for Children, Plastic Reconstructive Surgery and Burns Clinic, Bucharest, Romania
Address: Bd. Iancu de Hunedoara, no. 30-32, Bucharest, Romania
Email: ralu.tatar@gmail.com; Phone 0744636709