Pyogenic granuloma

Abstract

Pyogenic granuloma is a vascularized lesion, common in the oral cavity, not neoplasic, caused by trauma, local irritants or hormonal factors, with a higher prevalence in women, present more frequently in the mandible than in the maxilla. The first-choice treatment consists of removal of the local irritant factor, if any, and complete excision of the lesion. The objective of this work is to perform a clinical case report (CAEE nº 92256218.0.0000.5020) evidencing the clinical and histopathological characteristics of the pyogenic granuloma in a 36-year-old male, melanoderma, who attended the Department of Stomatology of the Faculty of Dentistry of the Federal University of Amazonas (FAO-UFAM). Intraoral examination, exfoliated, lobulated lesion with an increased volume of painless growth, softened consistency, with whitish borders, measuring approximately 2 centimeters, sessile base, highly vascularized appearance, ulcerated, bleeding when provoked, localized in the palatine gingiva, limited to the tooth region 23 to 26. Considering the characteristics of the lesion, anamnesis and the literature, the pyogenic granuloma and giant cell granuloma were defined as diagnostic hypotheses. We chose to perform supra and subgingival coronary scaling and excisional biopsy, and the piece was sent to the Pathology and Legal Medicine sector of the Faculty of Medicine of UFAM. In the histopathological examination, the lesion presented with epithelium characterized by areas of ulceration in its extension, a proliferation of endothelial cells in which they open in vascular spaces of varied sizes and most are obliterated by red blood cells. Fibroblastic proliferation with moderate deposition of collagen fibers and presence of exuberant chronic inflammatory cells characterized mainly by plasma cells and lymphocytes and also areas of hemorrhage, confirming the diagnosis of pyogenic granuloma. The patient is undergoing proservation, showing no signs of relapse after nine months of surgical excision.