“…In our case, the patient's pyogenic granuloma was 4.7 × 3.7 cm, which far exceeds the previously published average size of pyogenic granulomas, which ranges from 0.65 to 1.1 cm [3, 4]. There are a handful of giant cutaneous pyogenic granulomas that have been reported in the past, often in individuals with underlying immune dysfunction, but never in a patient with CLL [5, 6].…”
Pyogenic granuloma, also known as lobular capillary hemangioma, is a common benign vascular proliferative lesion that can present at any age on the skin or mucous membranes. Most lesions do not exceed 2 cm, but there are a handful of giant cutaneous pyogenic granulomas that have been reported, often in individuals with underlying immune dysfunction. Here, we report the first giant pyogenic granuloma in a patient with a hematological malignancy, chronic lymphocytic leukemia.
“…In our case, the patient's pyogenic granuloma was 4.7 × 3.7 cm, which far exceeds the previously published average size of pyogenic granulomas, which ranges from 0.65 to 1.1 cm [3, 4]. There are a handful of giant cutaneous pyogenic granulomas that have been reported in the past, often in individuals with underlying immune dysfunction, but never in a patient with CLL [5, 6].…”
Pyogenic granuloma, also known as lobular capillary hemangioma, is a common benign vascular proliferative lesion that can present at any age on the skin or mucous membranes. Most lesions do not exceed 2 cm, but there are a handful of giant cutaneous pyogenic granulomas that have been reported, often in individuals with underlying immune dysfunction. Here, we report the first giant pyogenic granuloma in a patient with a hematological malignancy, chronic lymphocytic leukemia.
“…Perhaps the increased infiammatory angiogenesis associated with these conditions also stimulates pericytic hyperplasia. Endocrine factors have also been suggested as contributory to vascular proliferation in pyogenic granuloma (48).…”
Pyogenic granuloma (lobular capillary hemangioma) is a common acquired vascular lesion of the skin and mucous membranes in the pediatric age group. This is a retrospective analysis of 178 patients, 17 years of age and younger (mean age 6.7 yrs). Forty-two percent of the lesions occurred in the first five years of life; only 12% appeared in infants less than 1 year old. The male:female ratio was 3:2. Most patients (74.2%) had no history of trauma or predisposing dermatologic condition. The mean lesional size was 6.5 mm and the mean duration at diagnosis was 3.8 months. The granulomas were most commonly located in the head and neck area (62.4%), followed in order of decreasing frequency by trunk (19.7%), upper extremity (12.9%), and lower extremity (5.0%). The preponderance (88.2%) occurred on the skin, the remaining ones involved the mucous membranes of the oral cavity and conjunctivae. Histologic examination demonstrated normal numbers of mast cells, in contrast to increased mast cells characteristic of proliferative phase hemangiomas. Most lesions (n = 149) were treated by full-thickness skin excision and linear closure; there were no recurrences in this group. The recurrence rate in 23 lesions treated by shave (intradermal) excision and cautery or cautery alone was 43.5%.
“…[78] Although it has been reported to occur in almost all age groups, it occurs mainly between 11 and 40 years with the peak incidence in 30 years. [9] A study by Skinner et al .…”
Pyogenic granuloma is an overzealously proliferative non-neoplastic lesion of connective tissue origin, found commonly in oral cavity and is secondary to chronic low grade local irritation, poor oral hygiene, and hormonal disturbances. The term is misnomer because a lesion is unrelated to infection. It is characterized by excessive and exuberant tissue repair response with varied inflammatory component. Since it is a benign lesion, choice of treatment is surgical excision with removal of underlying cause if any. This article aims at presenting a case of pyogenic granuloma in an extremely old patient which is unusual as it attained a very large size and also has caused mild resorption of underlying alveolar bone of mandible.
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