Le botryomycome

Pyogenic Granuloma in the Mandibular Anterior Gingiva: A Case Study

The oral cavity is frequently affected by gingival pyogenic granuloma (PG), a benign tumor that is known for its quick growth and tendency to hemorrhage. The clinical presentation, diagnostic procedure, and treatment of a patient with gingival pyogenic granuloma are all detailed in this case study. A female individual aged 25 years in otherwise good condition arrived with a sessile gingival tumor in the anterior mandibular region that was expanding quickly. During dental hygiene procedures, there was intermittent bleeding and discomfort related to the lesion. Based on histology analysis and clinical examination, PG was diagnosed. The course of treatment included surgical excision followed by a histological analysis to ensure total eradication. Appointments for follow-up revealed adequate healing and no indications of recurrence. This case study aims to demonstrate the need for prompt diagnosis, appropriate treatment, and diligent follow-up to effectively manage gingival pyogenic granuloma. Dental professionals can better treat patients and achieve better results with a thorough understanding of this common oral lesion and its management.

Herpes simplex virus type-I and pyogenic granuloma: a vascular endothelial growth factor-mediated association?

Pyogenic granuloma (PG) is a vascular endothelial growth factor (VEGF)-related neoangiogenic process. Minor trauma, chronic irritation, certain drugs and pregnancy may favor PG. Viral triggers have not been reported up to date. A 52-year-old woman with hairy-cell leukemia presented because of a 3-month history of a giant pseudotumoral lesion on her left cheek. All prior antibacterial, antifungal and anti-inflammatory treatments had failed. Histology revealed PG with sparse and isolated epithelial cell aggregates. Immunohistochemistry (IHC) identified herpes simplex virus type-I (HSV-I) antigens in the nuclei and cytoplasm of normal-appearing as well as cytopathic epithelial cells, suggesting a chronic, low-productive HSV infection. No HSV-I signal was evidenced in the endothelial cells of the PG. Furthermore, IHC revealed VEGF in the HSV-I infected epithelial cells as well as within the PG endothelial cells. These results incited oral treatment with valaciclovir, and the PG promptly resolved after 2 weeks. These findings suggest that a chronic HSV-I infection might play an indirect, partial role in neoangiogenesis, presumably via HSV-I infection-related stimulation of keratinocytic VEGF production.

[Neonatal botriomycoma of the tongue (a case report)]

INTRODUCTION

The botryomycoma is a benign tumor that develops as a response to a local trauma. Generally, it occurs in the fingers, the face and the oral cavity. It is often easily recognized. However, the diagnosis between this tumor and other oral tumors, whether benign or malignant, may be difficult in some cases. We report a particular case of a botryomycoma that occurred with no history of a trauma at an earlier age in the tongue, which is an unusual site for this tumor.

CASE REPORT

A 7-month-old infant presented with a polypoid and sessile swelling on the dorsal side of the tongue. This tumor gradually increased in size since birth. Clinically, the appearance of this mass with the gathered vessels inside was similar to that of a benign vascular tumor. A possibly malignant nature was not excluded. A complete resection under general anesthesia was performed. The histologic examination confirmed the diagnosis of pyogenic granuloma.

DISCUSSION

Pyogenic granuloma is a rare benign tumor which is most likely to occur between the age of 11 and 40. The most frequent location encountered for oral cavity is the gingiva. The tongue is rarely a site for its occurrence. Cutaneous pyogenic granuloma may have different aspect from mucosal type and thus may make the diagnosis difficult. Treatment consists on surgical excision and removal of etiological factors that may be source of recurrence.

Nasal cavity lobular capillary hemangioma due to insect sting

INTRODUCTION

Lobular capillary hemangioma is a frequent benign vascular inflammatory lesion of the skin tissue. It rarely reaches the mucous membrane, and the nasal fossa involvement is exceptional.

CASE REPORT

A 68-year-old woman presented with an ulcerous hemorrhagic mass blocking the left nasal fossa, which had appeared a few weeks after a wasp sting in the nose. The insect was evacuated only three weeks after the sting. The clinical and radiological data suggested malignancy. Biopsy under local anesthesia proved non-contributory and was complicated by 1 week's hospitalization for severe nosebleed. Surgical excision under video-endoscopy confirmed diagnosis. At 31 months' follow-up, the patient was free of recurrence.

DISCUSSION/CONCLUSION

The pathogeny of lobular capillary hemangioma is uncertain. No previous cases affecting the mucous membrane after insect sting have been reported. Except in the typical contexts of long-term packing or pregnancy, diagnosis can be difficult and misleading. It can mimic a malignant pathology. Its rich vascularization requires caution during biopsy, and the risk of recurrence requires excision to be complete.