Multifocal congenital pyogenic granuloma successfully treated with oral propranolol (original) (raw)
Congenital Disseminated Pyogenic Granuloma
Pediatric Dermatology, 2009
In the past pyogenic granuloma (PG) in infancy has been easily confused clinically and histopathologically with infantile hemangioma (IH). In 2000 North and colleagues discovered that IH is immunopositive for GLUT-1, a glucose transporter which is also expressed in placental capillaries (1). GLUT-1 staining is negative in pyogenic granuloma. We report two newborns with congenital disseminated PG who were otherwise healthy. In both of these cases, negative GLUT-1 staining supported the proper diagnosis.
International Journal of Clinical Pediatric Dentistry
Aim and objective: To give dental practitioners an insight into the unusual presentation of focal infantile hemangioma on the alveolar ridge showing immunoreactivity to glucose transporter-1 (GLT1). We also recommend the importance of using standardized terminologies to describe the type of hemangioma. Background: One of the most commonly seen and misdiagnosed vascular tumors of the skin and soft tissues of the head and neck region in children are infantile hemangiomas. Infantile hemangiomas developing at extracutaneous locations such as the oral cavity are rare, especially without cutaneous involvement. Case description: A 9-month-old infant girl presented to the Pediatric Dental Department with a swelling over the maxillary alveolar ridge. The solitary exophytic mass appeared after birth and gradually enlarged in size with episodes of bleeding during feeding. Clinical examination revealed a reddish-pink pedunculated mass that bled profusely on palpation. The lesion was excised by electrocautery and was found to be express glucose transporter-1 confirming the diagnosis of infantile hemangioma. The patient was followed up for 1 year and showed no recurrence. Conclusion: Hemangiomas are usually misinterpreted to be pyogenic granulomas, vascular malformation, reactive granulation tissue, or congenital granular cell tumor. This report highlights the use of glucose transporter-1 when there is suspicion of hemangioma for immunohistochemical distinction from other histologically similar vascular lesions of the oral cavity. Clinical significance: Dental surgeons treating vascular lesions of the oral cavity should advocate for surgical management techniques that also produce hemostasis due to the risk of intraoperative bleeding.
Uncommon location of pyogenic granuloma in a child – case report and mini-review
Archives of the Balkan Medical Union, 2020
Localisation peu fréquente du granulome pyogène dans l'enfance-cas clinique et mini-revue Introduction. Le granulome pyogène (GP) est une hyperplasie inflammatoire vasculaire qui affecte la peau et la muqueuse buccale, souvent associée à une irritation ou un traumatisme local, ou à une grossesse. La localisation intra-orale affecte généralement la gencive, mais l'aspect tumoral peut être trompeur, en particulier dans les localisations extra-gingivales. Une évaluation et un diagnostic approfondis sont donc importants pour garantir un traitement approprié. Présentation du cas. Nous présentons le cas d'un garçon de 12 ans qui est venu pour une consultation concernant la tumeur croissante et saignante de sa muqueuse de la lèvre inférieure. La tumeur a été étiquetée comme « hémangiome ». Elle se développait depuis plusieurs semaines et avait été associée à un traumatisme muqueux mineur mais répété. Bien que la localisation anatomique ne soit pas courante, les antécédents du patient suggéraient un diagnostic de GP. Après une consultation dermatologique qui proposait un diagnostic différentiel avec le papillome buccal, une échographie des tissus mous avait soutenu le diagnostic clinique. La tumeur a été excisée chirurgicalement et 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
Capillary Hemangioma Mimicking Pyogenic Granuloma: A Case Report
2018
Capillary haemangioma and pyogenic granuloma are well known and commonly occurring benign vascular malformations of the oral cavity exhibiting varied age from infants to late adulthood. Pyogenic granuloma occurs generally on the gingiva, whereas capillary haemangioma preferred sites are lips and tongue. Both lesions are very rarely seen on the palatal region1. Pyogenic granuloma is a relatively common, soft tissue tumour of the oral cavity that is believed to be reactive and non neoplastic in nature. The name pyogenic granuloma is a misnomer since the condition is not associated with pus and does not represent a granuloma histologically. 2 Haemangioma are the benign tumours composed of blood vessels and are classified on the basis of their histological appearance as capillary, mixed cavernous or a sclerosing variety that tends to undergo fibrosis 3. Haemangioma show characteristic feature of rapid endothelial cell proliferation, followed by involution over time. The proliferating ma...
SRM Journal of Research in Dental Sciences, 2020
Lobular capillary hemangioma (LCH), a histological variant of pyogenic granuloma (PG) is an inflammatory hyperplasia commonly seen on oral mucosa as a reaction to local irritants, trauma or hormonal influences. The term “PG” is a misnomer as it is neither pus filled nor representative of a granuloma histologically. It is an inflammatory lesion composed of proliferating vascular, fibrous, and inflammatory tissue. The benign tumor has varied clinical and histopathological presentations and occurs frequently on the gingiva in the oral cavity. The article presents a case report where 2-week propranolol therapy was used to manage oral LCH (with a rare site of presentation) in a 2-year-old preschooler with a 9-month follow-up showing no recurrence followed by review of literature.
Pyogenic granuloma. A case report
Journal of the American Podiatric Medical Association, 1973
Pyogenic granuloma is a fast growing reactive proliferation of endothelial cells commonly on the gingiva and usually in response to chronic irritation. It is a polypoid form of capillary hemangioma on the skin & mucosal surfaces. This paper present of case of pyogenic granuloma found on the cheek adjacent to retromolar region.
Initiation and Use of Propranolol for Infantile Hemangioma: Report of a Consensus Conference
Pediatrics, 2012
Infantile hemangiomas (IHs) are common neoplasms composed of proliferating endothelial-like cells. Despite the relative frequency of IH and the potential severity of complications, there are currently no uniform guidelines for treatment. Although propranolol has rapidly been adopted, there is significant uncertainty and divergence of opinion regarding safety monitoring, dose escalation, and its use in PHACE syndrome (PHACE = posterior fossa, hemangioma, arterial lesions, cardiac abnormalities, eye abnormalities; a cutaneous neurovascular syndrome characterized by large, segmental hemangiomas of the head and neck along with congenital anomalies of the brain, heart, eyes and/or chest wall). A consensus conference was held on December 9, 2011. The multidisciplinary team reviewed existing data on the pharmacologic properties of propranolol and all published reports pertaining to the use of propranolol in pediatric patients. Workgroups were assigned specific topics to propose protocols o...
Excellent Response of Infantile Hemangioma with Oral Propranolol: A Case Report
Berkala Ilmu Kesehatan Kulit dan Kelamin, 2022
Background: Infantile hemangioma (IH) is the most common benign tumor in infancy. Most IHs resolve spontaneously and do not require treatment. Therapeutic intervention is necessary for life-threatening IH, tumors posing functional risks, ulceration, and severe anatomic distortion, especially on the face. Beta-blockers, most specifically propranolol, have been shown to induce involution of IH, which should be administered as early as possible to avoid potential complications. Purpose: To report a case of IH with visual impairment treated successfully using oral propranolol. Case: A 4-month-old girl weighing, 6.3 kg, with redness plaques on the right face since 3 weeks after birth. The lesions rapidly increased in size within 2 months, and the lesions on her right eyelid made it difficult to open her right eye. Dermatological examination showed erythematous plaques, compressible and varying in size and ptosis. The patient was diagnosed with periocular infantile hemangioma and was given oral propranolol therapy with an initiated dose 3x1 mg. The dose was increased gradually. The lesions were significantly decreased and she could open her right eye normally after 5 months of propranolol therapy. Discussion: Some cases of IH require early treatment. Early treatment is indicated for IH causing functional impairment. The use of propranolol in the management of IH is very effective in the reduction of the lesions and Has minimal side effects. Conclusion: Early diagnosis and intervention with propranolol for IH play an important role in determining the optimal outcomes.