An aggressive pyogenic granuloma masquerading as a vascular neoplasm

| Posted in: Science Health Sciences Journals

Journal name: Journal of Indian Society of Periodontology
Original article title: An aggressive pyogenic granuloma masquerading as a vascular neoplasm
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
This page presents a generated summary with additional references; See source (below) for actual content.

Original source:

This page is merely a summary which is automatically generated hence you should visit the source to read the original article which includes the author, publication date, notes and references.

Author:

Shravya Jaganath Shetty, Kaveri Hallikeri, Venkatesh Anehosur, Anil Desai


Journal of Indian Society of Periodontology:

(A bimonthly open-access journal)

Full text available for: An aggressive pyogenic granuloma masquerading as a vascular neoplasm

Year: 2020 | Doi: 10.4103/jisp.jisp_459

Copyright (license): CC BY-NC-SA


Summary of article contents:

Introduction

Pyogenic granuloma (PG) is a benign, reactive hyperplastic lesion frequently observed in the gingiva, particularly among young women due to hormonal influences. Often linked to local irritation or trauma, PG can exhibit aggressive behavior, leading to significant clinical complications, including excessive bleeding and alveolar bone loss. This report highlights a rare and destructive case of PG in an 18-year-old female characterized by multiple recurrences, culminating in the loss of maxillary anterior teeth and requiring extensive therapeutic interventions.

Aggressive Nature of Pyogenic Granuloma

In the described case, the patient first presented with a well-defined lesion that underwent multiple recurrences over a five-year span. The most concerning recurrence exhibited rapid growth and marked bone resorption, mimicking a malignant vascular neoplasm. Histological analysis revealed increased vascularity and endothelial cell proliferation along with chronic inflammatory infiltrates. The aggressiveness of PG, particularly in its destructive nature and propensity for bleeding, underscores the importance of careful diagnosis and management. It is crucial for clinicians to recognize this condition's potential to evolve into a more severe form, thereby avoiding misdiagnosis and inappropriate treatment approaches.

Conclusion

Pyogenic granuloma, while a benign lesion, can exhibit severe clinical manifestations that may lead to significant tissue loss and complications if not adequately addressed. Complete excision down to the periosteum or periodontal ligament is essential to manage PG effectively and prevent recurrences. Regular follow-up is vital for maintaining oral hygiene and monitoring for potential recurrence, as aggressive presentations can pose serious challenges. Clinicians must remain cognizant of PG's deceptive nature to ensure proper diagnosis and treatment.

FAQ section (important questions/answers):

What is pyogenic granuloma and whom does it affect?

Pyogenic granuloma (PG) is a benign vascular lesion commonly affecting females, particularly during their second decade of life. It is often associated with local irritation or trauma and appears as a nodular growth on the gingiva.

What were the symptoms of the reported case of PG?

In the reported case, an 18-year-old female experienced excessive bleeding, a large ulcerated lesion, and significant loss of the maxillary anterior teeth due to the destructive nature of the recurrent PG.

How is pyogenic granuloma diagnosed and treated?

PG is diagnosed through clinical examination and histopathology, which reveals increased vascularity and cellular proliferation. Treatment involves complete excision of the lesion to prevent recurrence, often combined with currettage.

What complications can arise from untreated pyogenic granuloma?

Untreated PG can lead to significant complications, including uncontrolled bleeding, loss of alveolar bone, and mobility of the associated teeth, which may compromise both function and aesthetics.

What is the follow-up procedure after treatment for pyogenic granuloma?

Post-treatment, close follow-up is essential to monitor for recurrence. Patients must maintain good oral hygiene to prevent the lesion from reoccurring.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “An aggressive pyogenic granuloma masquerading as a vascular neoplasm”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
A table in this context refers to a structured arrangement of data or information that allows for comparison and analysis. It often summarizes key findings or results, helping to clarify differences between diagnoses, clinical features, histopathological characteristics, and differentiating features of various lesions. This aids clinicians in making informed decisions.

2) Relative:
In this document, relative pertains to the comparison of characteristics such as age and gender demographics concerning the prevalence of pyogenic granuloma. This contextual understanding is essential for identifying patient risk factors, establishing effective diagnosis, and treating the condition appropriately based on relative factors that impact its presentation.

3) Bleeding:
Bleeding is a significant clinical feature associated with pyogenic granuloma, observed during its development or recurrence. It highlights the lesion's vascular nature and indicates the urgency for medical intervention. The document details excessive bleeding incidents experienced by the patient, impacting treatment decisions and emphasizing the condition's aggressive behavior.

4) Blood:
Blood is vital for understanding the physiological implications of pyogenic granuloma, particularly its vascular proliferation and potential complications like excessive blood loss. The text mentions multiple transfusions required for the patient due to significant bleeding during treatment, which illustrates the severity of the lesion and its clinical management needs.

5) Channel:
In this context, channel refers to the vascular structures within the pyogenic granuloma. The proliferation of channels plays a critical role in the diagnosis, indicating a high degree of vascularity that may resemble malignancy. Understanding these channels helps differentiate PG from other vascular neoplasms based on their organization and characteristics.

6) Swelling:
Swelling relates to the physical manifestation of the pyogenic granuloma as it often presents as a mass in the oral cavity. This symptom signifies the lesion's growth and underlying inflammatory response. Clinicians evaluate swelling to determine the severity of the condition and to decide on an appropriate treatment approach.

7) Surface:
Surface refers to the outer appearance of the pyogenic granuloma, which can display ulceration and vascular characteristics. Observing the surface features contributes to the clinical diagnosis of the condition. Analysis of the surface assists in understanding the lesion’s behavior, risk of bleeding, and helps formulating effective surgical interventions.

8) Life:
Life, in the medical context, implies considerations of the patient's overall health and well-being in relation to their condition, emphasizing the importance of preventive measures, effective treatment modalities, and monitoring for recurrences. The document highlights the lasting impact of pyogenic granuloma on a young patient’s dental and aesthetic life.

9) Inflammation:
Inflammation is a key pathological process involved in the development of pyogenic granuloma, serving as both a symptom and contributor to its growth. Chronic inflammation triggers excessive tissue repair responses, leading to increased vascularity and the potential for recurrence. Understanding inflammation is crucial for diagnosis and management strategies.

10) Discussion:
Discussion encompasses the analysis and interpretation of clinical findings, highlighting the complexities of diagnosing pyogenic granuloma. It includes exploring clinical behaviors, histopathological features, and comparing them to potential differential diagnoses. This section serves as a critical component for clinicians to evaluate patient cases and refine treatment protocols.

11) Developing:
Developing refers to the progression and alteration of the pyogenic granuloma from an initial presentation through recurrences. This aspect emphasizes the dynamic nature of the lesion, impacting clinical decision-making. Understanding how the lesion develops over time helps clinicians anticipate complications and adjust treatment strategies accordingly.

12) Irritation:
Irritation may be a precipitating factor for the formation of pyogenic granuloma, often associated with local trauma or chronic inflammation. Recognizing underlying causes of irritation is essential for prevention, management, and relapse of the lesion, thereby aiding clinicians in providing comprehensive treatment and patient education.

13) Substance:
Substance refers to the chemical or biological components involved in the pathogenesis of pyogenic granuloma, including angiogenic factors and inflammatory mediators. Understanding these substances’ roles is vital for comprehending the mechanisms driving the lesion's formation, guiding both diagnostic approaches and therapeutic interventions.

14) Hygiene (Hygienic):
Hygiene emphasizes the importance of oral cleanliness in preventing infection and managing complications associated with pyogenic granuloma. Maintaining good oral hygiene is crucial for minimizing recurrence risks and promoting healing post-treatment, as highlighted in the recommendations for the patient’s ongoing care to ensure optimal health outcomes.

15) Repair:
Repair refers to the body’s healing processes in response to injury or damage, which is central to the formation of pyogenic granuloma. The exaggerated tissue repair mechanisms can lead to hyperplastic growth, complicating diagnosis and treatment. Understanding the balance between repair and pathology is essential in clinical settings.

16) Nature:
Nature pertains to the fundamental characteristics of pyogenic granuloma, being a benign and reactive hyperplastic lesion. Recognizing the nature helps differentiate it from malignant disorders. Knowledge of its intrinsic properties guides clinicians in managing the condition effectively and mitigating risks of misdiagnosis.

17) Rules:
Rules in this context may refer to the established guidelines and protocols that govern the diagnosis and management of lesions like pyogenic granuloma. Adherence to best practices is crucial to ensure patient safety, optimize treatment outcomes, and streamline clinical decision-making aligned with current medical standards.

Other Health Sciences Concepts:

[back to top]

Discover the significance of concepts within the article: ‘An aggressive pyogenic granuloma masquerading as a vascular neoplasm’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

Differential diagnosis, Oral hygiene, Histopathological examination, Corticosteroids treatment, Vascular channels, Bleeding time, Hormonal change, Alveolar bone, Complete excision, Pyogenic granuloma, Local irritation, Excisional biopsy, Female predilection, Capillary hemangioma, Maxillary anterior teeth, Recurrent lesion, Angiosarcoma, Severe consequences.

Let's grow together!

I humbly request your help to keep doing what I do best: provide the world with unbiased sources, definitions and images. Your donation direclty influences the quality and quantity of knowledge, wisdom and spiritual insight the world is exposed to.

Let's make the world a better place together!

Like what you read? Help to become even better: