with a chief complaint of spontaneous bleeding from gums since 1 month. The patient had consulted a physician who discerned a swelling in 43-45 tooth region. There was no associated pain. Patient was asthmatic and had a psychogenic disorder. He was under medication for these conditions. The patient was using corticosteroids, salbutamol by inhalation, for last nine years. The patient had smoking habit for 39 years but was non-alcoholic. The patient appeared chronically ill and drowsy but could be awakened easily. The pulse rate was 95/min; fast and irregular but veins appeared thickened on palpation. Respiratory rate, temperature and blood pressure were within normal limits. Right sub-mandibular and upper cervical lymph nodes were palpable but mobile and nontender. The patient passed black, sticky and tarry stools however micturition habits were normal.On intraoral inspection, a growth of about 1.5 X 2.5 cm was noticed in relation to 43-47 region [Table /Fig-1a]. The surface of the swelling was smooth and erythematous. On palpation, the growth was nontender and soft in consistency. It measured 1.7 X 2.3 X 1.4 cm, extended from distal aspect of 43 to mesial aspect of 47 and bled even on slight provocation. The margins were well defined. Oral hygiene was poor. Panoramic radiograph showed generalized bone loss [Table/ Fig-1b&c]. A clinical diagnosis of pyogenic granuloma was made and a piece of tissue was incised which was fixed in 10% formalin and sent to the Department of Oral Pathology and Microbiology for histopathological examination.