Pediatric Intranasal Lobular Capillary Hemangioma: A Scoping Review and Multimedia Case Presentation.

STUDY DESIGN: Systematic, scoping literature review and case presentation. OBJECTIVE: The goal of this study is to review current literature on management trends and outcomes of pediatric intranasal lobular capillary hemangioma (ILCH). CASE PRESENTATION: A 14-year-old male patient presented with a 15-month history of unilateral epistaxis, nasal congestion, and mouth breathing. Further workup revealed a pale nasal mass obstructing the right nasal cavity. The patient was successfully treated using a minimally invasive endoscopic endonasal approach for mass resection and nasal floor free mucosal graft for septal reconstruction. METHODS: Independent queries of the PubMed Central, MEDLINE, and Bookshelf databases were performed; articles from 1990 to 2023 were abstracted. All studies that described pediatric ILCH using the Boolean method and relevant search term combinations, including "Intranasal," "Lobular capillary hemangioma," "Pyogenic granuloma," "Pediatric," "Outcome," and "Management," were collected for subsequent analysis. RESULTS: A total of 407 relevant unique articles were identified for analysis. Of these, 19 articles were deemed appropriate for inclusion in this literature review. Twenty-two pediatric ILCH cases were identified with a mean age at diagnosis of 10.5 years. The majority of cases occurred in males and presented with recurrent epistaxis and nasal obstruction. Most lesions originated from the anterior nasal septum and were resected using an endoscopic endonasal approach with no recurrence at last follow-up. CONCLUSIONS: Pediatric ILCH, a benign vascular neoplasm, often presents with unilateral nasal obstruction and severe, refractory epistaxis. This comprehensive review aims to highlight the importance of including this lesion in the differential diagnosis for unilateral nasal obstruction and epistaxis in young children.

Role of collagen and immunostaining for TGF-ß in the clinical and microscopic findings of pyogenic granuloma and peripheral ossifying fibroma.

BACKGROUND: Collagen is a component of Pyogenic Granuloma (PG) and Peripheral Ossifying Fibroma (POF) and performs different functions in these lesions. The objective of this study is to evaluate the role of collagen and immunostaining for Transforming Growth Factor beta (TGF-ß) in the clinical and microscopic findings of PG and POF. MATERIAL AND METHODS: PG (n=20) and POF (n=20) were selected for clinical evaluation (sex, age, localization, size and evolution time) and microscopic analysis (picrosirius red staining for collagen analysis and immunohistochemistry for TGF-ß) performed in the superficial and deep areas of the two lesions. ANOVA/Bonferroni and t-test, Pearson correlation and χ2 were used to compare the sites and parameters analyzed (p<0.05, GraphPad Prism 5.0). RESULTS: The depth of PG presented the highest amount of collagen (p<0.001), and its surface showed the lowest amount of type 1 collagen (yellow-red strong birefringence). Type 1 collagen gradually increased in depth of PG, surface and depth of POF (p<0.001). The number of TGF-ß+ cells was lower on the surface of PG compared with the depth of PG and the two areas of POF (p<0.001). Sex and localization did not affect these parameters, but the profile of collagen and immunostaining for TGF-ß suffered from modifications by the time of evolution and the size of the lesion. CONCLUSIONS: Although PG and POF are reactive gingival lesions, the expression of TGF-ß and its role in collagen showed different biological behaviors in these lesions, suggesting different biological origins for its components.

Oral Pyogenic Granuloma: A Narrative Review.

Pyogenic granuloma (PG) is a benign vascular lesion found predominantly in the oral cavity. Characterized by rapid growth and propensity to bleed, PG presents diagnostic challenges due to its similarity and alarming proliferation. This narrative review synthesizes current knowledge on the epidemiology, etiopathogenesis, clinical manifestations, and management of oral PG, with emphasis on recent advances in diagnostic and therapeutic approaches. The epidemiology of the injury is meticulously analyzed, revealing a higher incidence in women and a wide range of ages of onset. It delves into the etiopathogenesis, highlighting the uncertainty surrounding the exact causal factors, although historical attributions suggest an infectious origin. It exhaustively analyzes the clinical and histopathological aspects of oral PG, offering information on its various presentations and the importance of an accurate diagnosis to guide effective treatment. It details treatment strategies, emphasizing the personalized approach based on individual patient characteristics. This comprehensive review consolidates current knowledge on oral PG, highlighting the need for further research to clarify its pathogenesis and optimize treatment protocols.

Angioleiomioma oral mimetizando um granuloma piogênico: relato de caso raro / Oral Angioleiomyoma mimetizing a pyogenic granuloma: A rare case report

Angioleiomioma (AL) é um tumor benigno de origem perivascular que raramente é observado na cavidade oral, principalmente em localizações como a gengiva. Devido sua apresentação clínica inespecífica, os ALs podem mimetizar outras lesões orais, como tumores benignos de glândulas salivares e lesões reacionais, como o granuloma piogênico. O presente artigo objetiva relatar um caso raro de AL localizado em gengiva, em uma paciente de 19 anos. Clinicamente, a lesão apresentava-se como um tumor assintomático, oval, pedunculado, bem definido, com superfície lisa, consistência fibrosa e cor eritematosa, semelhante a um granuloma piogênico, Uma biópsia excisional foi realizada e o fragmento foi encaminhado para análise histopatológica, que revelou uma proliferação vascular de diversos calibres, contendo paredes musculares espessas e proliferação muscular adjacente, além de infiltrado inflamatório, predominantemente crônico, hemácias extravasadas e área de ulceração, consistente com o diagnóstico de AL inflamado. A histopatologia desempenha um papel importante no diagnóstico final de lesões raras e com características clínicas inespecíficas. A excisão cirúrgica da lesão é o tratamento de escolha mais eficaz para os ALs orais. (AU)

Angioleiomyoma (AL) is a benign tumor of smooth muscle of perivascular origin that is rarely seen in the oral cavity, mainly in locations like the gingiva. Due to their nonspecific clinical presentation, ALs can mimic other oral lesions, such as benign salivary gland tumors and reactional lesions, as a pyogenic granuloma. We reported a case of an AL located in the gingiva in a 19-year-old female patient. In clinical terms, the lesion was presented as an asymptomatic, oval, pedunculated, well-defined nodule with a smooth surface, fibrous consistency and erythematous color, similar to a pyogenic granuloma. An excisional biopsy was performed and the fragment was sent for histopathological analysis that revealed a vascular proliferation of different calibers, containing thick muscle walls and adjacent muscle proliferation, in addition to an inflammatory infiltrate, predominantly chronic, extravasated red blood cells and an area of ulceration, consistent with the diagnosis of inflamed AL. The histopathology plays an important role in the final diagnosis of rare lesions and with nonspecific clinical characteristics. The surgical excision of the lesion is the most effective treatment of choice for oral ALs. (AU)

Granuloma piógeno en el dorso lingual: caso clínico / Pyogenic granuloma in the lingual dorsum: a clinical case

El granuloma piógeno es una lesión benigna en la cavidad bucal, no neoplásica. Es una entidad fre- cuentemente asociada a la expansión de los tejidos blandos de la cavidad bucal. Se presenta, con mayor frecuencia, en individuos del género femenino, con edades comprendidas entre la segunda y cuarta década de vida. El tratamiento es mediante escisión quirúrgica con un pequeño margen de seguridad, y los agentes irritantes deben extraerse concomitan- temente para la curación de la lesión. Este trabajo tuvo como objetivo informar un caso de granuloma piógeno en el dorso de la lengua en una paciente del género femenino de 69 años. Los autores destacaron la importancia del conocimiento de la patología bucal por parte del Cirujano Dentista para poder realizar un correcto diagnóstico diferencial de otras lesiones, con el fin de realizar el tratamiento adecuado (AU)

Pyogenic granuloma is a quite common non-neoplasic benign lesion in the oral cavity. It is one of the entities most frequently associated with the soft tissues' expansion of the oral cavity, specifically in females, in the age group between the second and the fourth decade of life. The treatment is by surgical excision with a small margin of safety. For the healing of the lesion irritants should be concomitantly removed. This study aimed to report a case of pyogenic granuloma on the lingual dorsum of a 69-year-old female patient. The authors concluded highlighting the importance of the knowledge of oral pathology by the Dental Surgeon, to perform a correct differential diagnosis of other lesions to perform the appropriate treatment (AU)

Granuloma piógeno oral. Serie de casos / Oral pyogenic granuloma. Case series

RESUMEN El granuloma piógeno es una lesión que se manifiesta en la piel y en la cavidad oral, relacionado con diversas causas, como irritación crónica, trauma y cambios hormonales. Clínicamente se muestra como una lesión hiperplásica altamente vascularizada, con un tamaño de 1-3 cm, de base pedunculada o sésil y de crecimiento lento. Predomina en el sexo femenino y tiende a aparecer, sobre todo, en la encía, con muy pocos casos reportados en zonas edentes, motivo por el que se realizó el reporte de tres casos de granuloma piógeno oral en pacientes femeninas, comprendidas entre 30 y 40 años de edad. Se presentaron lesiones que diferían en cuanto a su localización y apariencia clínica (AU).

ABSTRACT Pyogenic granuloma is a lesion that arises in the skin and oral cavity, related to various causes, such as chronic irritation, trauma and hormonal changes. Clinically it looks like a highly vascularized hyperplastic lesion, sized 1-3 cm, with a pedunculated or sessile base and slow growing. It predominates in the female sex and tends to appear, above all, in the gum, with very few cases reported in edentulous areas; that is why the authors reported three cases of oral pyogenic granuloma in female patients, aged between 30 and 40 years. The lesions differed in their location and clinical appearance (AU).

Conjunctival pyogenic granuloma during pregnancy.

Pyogenic granuloma is a common benign, vascular lesion of the skin and mucosa. Our case was a 34-year-old woman at 28 weeks of gestation. She presented with a complaint of a growing and occasionally bleeding mass on the left lower eyelid conjunctiva for approximately 3 months. On examination, a red, pedunculated fragile lesion on the medial lower eyelid conjunctiva was observed. Ophthalmologic examination revealed that visual acuity was 20/20 in both eyes. Anterior and posterior segment examination was normal bilaterally. The lesion was excised completely under local anesthesia and sent for pathological examination. Histopathological examination revealed multiple vascular structures with small-diameters in the fibrous stroma. Vessels showed strong CD31 expression in immunohistochemical staining. Kaposi sarcoma was excluded due to negative HHV-8 staining. These findings were diagnostic of pyogenic granuloma. The frequency of pyogenic granuloma increases during pregnancy and surgical excision is important in diagnosis and treatment of these patients. This is the first reported case of conjunctival pyogenic granuloma during pregnancy.

Oral pyogenic granuloma: An 18-year retrospective clinicopathological and immunohistochemical study.

BACKGROUND: Pyogenic granuloma (PG) is a lesion characterized by the proliferation of blood vessels, commonly affecting the skin and the mouth. We aimed to compare clinical, microscopic, and immunohistochemical features of the two types of oral PG: lobular capillary hemangioma (LCH) and non-LCH (NLCH). METHODS: Epidemiological and clinical data from 2000 to 2018 were collected from the archives of our institution, and histopathological sections of PG were reviewed. Immunohistochemical analyses (CD34, D2-40, SMA, mast cell, and Ki-67) were performed in 34 cases. RESULTS: Sixty-two LCH and 107 non-LCH samples were included. The mean (±SD) age of the patients was 38.59 ± 16.96 years; 55.62% were female; 39.64% of cases occurred in the gingiva, 44% of the nodules were pedunculated, and 13.02% of patients reported a history of trauma. NLCH was more prevalent among older patients than LCH. The most prevalent site of LCH was the lips, while NLCH occurred more in the gingiva (P < 0.05). Epithelial atrophy, microvessels, SMA-positive areas, and Ki-67-positive nuclei were more prevalent in LCH (P < 0.05). CONCLUSIONS: PG accounted for 2.25% of lesions archived in the pathology service and most cases were NLCH. LCH and NLCH exhibited clinicopathological differences in terms of age, site, epithelial atrophy, vascularization, and proliferation rate.

Granuloma piógeno oral recurrente con pérdida ósea alveolar y movilidad dentaria: Reporte de un caso inusual / Granuloma piogênico oral recorrente com perda óssea alveolar e mobilidade dental: Relato de um caso incomum / Recurrent oral pyogenic granuloma with alveolar bone loss and tooth mobility: report of an unusual case

Resumen El granuloma piógeno oral es una lesión benigna multifactorial, caracterizada por presentarse como un agrandamiento gingival muy vascularizado. Se puede localizar en cualquier área de la cavidad oral, con más frecuencia en la encía marginal vestibular. Se presenta con mayor incidencia en mujeres adultas y en niños varones. No suele comprometer tejido óseo ni dientes y su tratamiento más seguro es la exéresis quirúrgica, siendo el riesgo de recurrencia alto. El objetivo del presente estudio es reportar el caso de una paciente de 9 años de edad, que fue sometida a la exéresis de un granuloma piogénico oral en el hueso maxilar y al año siguiente presentó una recurrencia de la lesión con pérdida ósea alveolar y movilidad de un diente adyacente. Se le realizó una biopsia y un curetaje minucioso, confirmándose el diagnostico de granuloma piogénico oral.

Resumo O granuloma piogênico oral é uma lesão multifatorial benigna, caracterizada por apresentarse como um aumento gengival altamente vascularizado. Pode estar localizado em qualquer área da cavidade oral, mais frequentemente na gengiva marginal vestibular. Ocorre com maior incidência em mulheres adultas e em crianças do sexo masculino. Geralmente não compromete o tecido ósseo ou os dentes e seu tratamento mais seguro é a escisão cirúrgica, sendo alto o risco de recorrência. O objetivo do presente estudo é relatar o caso de uma paciente de 9 anos de idade, submetida a escisão de granuloma piogênico oral no maxilar e no ano seguinte apresentou uma recorrência da lesão com perda óssea alveolar e a mobilidade de umo de seus dentes adjacentes. Uma biópsia e uma curetagem completa foram realizadas, confirmando o diagnóstico de granuloma piogênico oral.

Abstract Oral pyogenic granuloma is a benign multifactorial lesion that appears as a highly vascular gingival enlargement. It can be located anywhere in the oral cavity, most often in the vestibular marginal gingiva. It occurs most frequently in adult women and male children. It does not usually compromise bone tissue or teeth; its safest treatment is surgical excision, with a high recurrence risk. This study aims to report the case of a 9-year-old female patient who underwent oral pyogenic granuloma excision in the maxilla. The following year, she presented a possible lesion recurrence with alveolar bone loss and the mobility of an adjacent tooth. A biopsy and thorough curettage were performed, confirming the diagnosis of oral pyogenic granuloma.

Doença periodontal como fator determinante para a recidiva do granuloma piogênico / Periodontal disease as a determining factor for piogenic granumola recurrence

O presente estudo tem como objetivo descrever por meio de um caso clínico o diagnóstico e a conduta clínica no tratamento de um Granuloma Piogênico (GP) recidivante associado à doença periodontal. O GP é uma lesão inflamatória hiperplásica que se encontra nos tecidos moles da cavidade bucal e que possui um crescimento reagente estimulado por irritação local de baixa intensidade, fator hormonal ou trauma, podendo causar desconforto ao paciente e interferir na fala e mastigação. O GP acomete principalmente mulheres na segunda e terceira décadas de vida em regiões como gengiva, lábios, língua e mucosa bucal. O tratamento do GP consiste em excisão cirúrgica e o diagnóstico decisivo é realizado por meio de exame histopatológico. Paciente do gênero feminino, 57 anos, procurou atendimento no Centro Universitário da Serra Gaúcha ­ FSG por apresentar lesão rósea pediculada na região de papila incisiva com cerca de 2 cm de diâmetro. A paciente foi submetida a dois procedimentos cirúrgicos e em ambos ocorreu a recidiva. A completa excisão da lesão somente foi realizada após realização de tratamento periodontal e remoção de fatores irritantes como biofilme e cálculo dentário. Desta forma, foi possível concluir que é de suma importância a observação e remoção dos fatores irritantes durante o tratamento do GP e que desta maneira se diminuiu as chances de posterior recidiva(AU)

The present study aims to describe through a clinical case the diagnosis and clinical management treatment of a recurrent Piogenic Granuloma (GP) associated with periodontal disease. PG is a hyperplastic inflammatory lesion found in the soft tissues of the oral cavity and has a reactive growth stimulated by low intensity local irritation, hormonal factor or trauma, which may cause patient discomfort and interfere with speech and chewing. GP affects mainly women in the second and third decades of life in regions such as gums, lips, tongue and oral mucosa. The treatment of GP consists of surgical excision and the decisive diagnosis is made by histopathological examination. Female patient, 57 years old, attended the University Center of Serra Gaúcha - FSG presenting pediculated pink lesion in the incisive papilla region with about 2 cm in diameter. The patient underwent two surgical procedures and both relapsed. Complete excision of the lesion was only performed after periodontal treatment and removal of irritating factors such as biofilm and dental calculus. Thus, it was possible to conclude that the observation and removal of irritating factors during the treatment of GP is of paramount importance and thus reduced the chances of further relapse(AU)

Congenital Disseminated Pyogenic Granuloma: Characterization of an Aggressive Multisystemic Disorder.

OBJECTIVE: To describe the clinical, radiologic, and histopathologic features of "congenital disseminated pyogenic granuloma" involving various organs with high morbidity related to cerebral hemorrhagic involvement. STUDY DESIGN: We searched the database of the Vascular Anomalies Center at Boston Children's Hospital from 1999 to 2019 for patients diagnosed as having multiple vascular lesions, visceral vascular tumors, congenital hemangiomatosis, multiple pyogenic granulomas, or multiple vascular lesions without a definite diagnosis. A retrospective review of the medical records, photographs, histopathologic, and imaging studies was performed. Only patients with imaging studies and histopathologic diagnosis of pyogenic granuloma were included. RESULTS: Eight children (5 male, 3 female) had congenital multifocal cutaneous vascular tumors. Lesions also were found in the brain (n = 7), liver (n = 4), spleen (n = 3), muscles (n = 4), bone (n = 3), retroperitoneum (n = 3), and intestine/mesentery (n = 2). Less commonly affected were the spinal cord, lungs, kidneys, pancreas, and adrenal gland (n = 1 each). The mean follow-up period was 21.8 months. The cerebral and visceral lesions were hemorrhagic with severe neurologic sequelae. The histopathologic diagnosis was pyogenic granuloma with prominent areas of hemorrhage and necrosis. The endothelial cells had enlarged nuclei, pale cytoplasm and were immunopositive for CD31 and negative for D2-40 and glucose transporter 1. CONCLUSIONS: Congenital disseminated pyogenic granuloma is a distinct multisystemic aggressive disorder that primarily affects the skin, brain, visceral organs, and musculoskeletal system. Differentiation of this entity from other multiple cutaneous vascular lesions is critical because of possible cerebral hemorrhagic involvement.

Congenital cutaneous pyogenic granuloma: Report of two cases and review of the literature.

Congenital cutaneous pyogenic granuloma is a rare benign vascular tumor with clinical and histopathological features similar to infantile hemangioma. It usually presents as a red, pedunculated and highly friable papule. On histopathological analysis, one can see a capillary vessel proliferation with lobular pattern and endothelial proliferation. The differential diagnosis is based on negativity of glucose transporter 1 (GLUT1) immunochemistry studies. We report two infants with congenital pyogenic granuloma, one with a unique cutaneous lesion and the other with multiple lesions affecting both skin and mucosal surfaces. These two cases highlight the importance of the differential diagnosis based on the GLUT1 immunochemistry analysis considering the distinct treatments required to these infant vascular tumors.

Esophageal Pyogenic Granuloma: A Case Report and Review of the Literature.

Pyogenic granuloma (PG) is a capillary hemangioma mainly found in the skin and oral mucosa, but rarely described in the esophagus. We report the case of a 66-year-old man who consulted for retrosternal pain. Endoscopic studies showed a 28-mm polypoid mass located at the distal esophageal mucosa. The patient underwent endoscopic resection, and the histopathological examination showed a neoplastic proliferation of small blood vessels growing in a lobular architecture, with edematous stroma and prominent inflammatory infiltrate. Special stains for fungus showed pseudohyphae compatible with Candida spp. Findings were consistent with those of an esophageal PG associated with Candida infection. This case is a reminder that PG can be found in the esophagus, can be associated with other entities such as Candida infection, and is one of the differential diagnoses of neoplastic vascular proliferations that may mimic malignancy. In addition, we reviewed previously reported cases of esophageal PG.

A mixed form of intravascular papillary endothelial hyperplasia in an uncommon location: case and literature review.

Intravascular papillary endothelial hyperplasia (IPEH) is an unusual benign, non-neoplastic vascular lesion that usually occurs in skin, but is uncommon in the oral cavity. Herein, we review the pertinent literature of oraiiPEH and report a new mixed form. A 61-year- old man presented with an ulcerated nodule in the lingual portion of the gingiva related to the left mandibular canine. An excisional biopsy was performed presuming the clinical diagnosis of pyogenic granuloma. Histopathological analysis showed areas of granulation tissue consistent with pyogenic  granuloma. But in  addition, there  were thin-wall dilated vessels with papillary projections of endothelial cells producing vascular channels, associated with  an area of  organizing  thrombus. These microscopic findings led to the diagnosis of pyogenic  granuloma  associated with  IPEH. The immunohistochemical  reactions revealed a diffuse positivity of the vascular cells for CD-34 and smooth muscle actin antibodies.In addition,there was partial positivity for podoplanin and negativity for CD-1OS in the IPEH areas. No signs of recurrence were observed after 6 months of follow-up. The most prevalent site of IPEH in the oral region is the lower lip. IPEH is slightly more common in women and exhibits peaks of prevalence between the fourth and sixth decades of life.

A challenging diagnosis: Case report of oral metastasis from gastric adenocarcinoma mimicking pyogenic granuloma.

RATIONALE: Oral metastases occur more commonly in bone, but can also manifest in soft tissues and eventually resemble a reactive lesion. Few cases of oral metastases mimicking reactive lesions in soft tissues have been reported to date. PATIENT CONCERNS: We report a metastasis of gastric carcinoma (GC) to the oral mucosa without bone involvement in a 43 yom clinically and microscopically mimicking a reactive lesion. The patient related that the lesion had 1 month of evolution, and the ulcerated area suggested the lesion was related to trauma. DIAGNOSES: The histopathological examination of the lesion revealed an exuberant granulation tissue with few neoplastic cells, and the initial diagnosis of pyogenic granuloma was considered. In a second analysis, clusters of clear cells morphologically similar to degenerating mucous cells or macrophages, positive for Cytokeratin (CK)-20, and CDX2 were found. At the moment, it was confirmed the presence of a primary GC in the patient. INTERVENTIONS: A palliative radiotherapy/chemotherapy was started. OUTCOMES: However, the patient died 3 months after the diagnosis of oral metastasis. LESSONS: This report highlights the importance of careful clinical and microscopic examinations in cases of oral metastasis that may mimic a reactive lesion.

Granuloma telangiectásico bucal / Oral telangiectatic granuloma

Introducción: el granuloma telangiectásico es un tumor reactivo inflamatorio en la cavidad bucal a causa de factores irritativos, traumafísico o factores hormonales. Es más frecuente en el sexo femenino entre la segunda y sexta décadas de la vida. Objetivo: describir los hallazgos clínico-patológicos del granuloma telangiectásico bucal, su posible patogénesis, diagnóstico diferencial y manejo terapéutico. Presentación de casos: se obtuvieron los datos de edad, género y diagnóstico clínico de una serie de cinco casos de granuloma telangiectásico bucal diagnosticados en la Facultad de Odontología de la Universidad de Cartagena entre el año 2016 y 2017. Se describen características clínicas, histológicas, factores etiológicos y sintomatología presentada en cada uno de ellos. El diagnóstico se realizó mediante histopatología y se confirmó como granuloma telangiectásico. En la totalidad de los casos el tratamiento realizado fue netamente quirúrgico. Conclusiones: es importante que los profesionales en odontología conozcan todos y cada uno de los aspectos relacionados con el granuloma telangiectásico, características clínicas, histológicas y los factores etiológicos, con el objeto de poder ofrecer un diagnóstico certero y, por consiguiente, un adecuado plan de tratamiento(AU)

Introduction: telangiectatic granuloma is an inflammatory reactive tumor of the oral cavity caused by irritating agents, physical trauma or hormonal factors. It is more frequent in the female sex between the second and sixth decades of life. Objective: describe the clinical-pathological findings of oral telangiectatic granuloma, as well as its possible pathogenesis, differential diagnosis and therapeutic management. Case presentation: data were obtained about the age, sex and clinical diagnosis of a series of five cases of oral telangiectatic granuloma diagnosed at the School of Dentistry of the University of Cartagena in the period 2016-2017. A description is provided of clinical and histological characteristics, etiological factors and symptoms of each case. Histopathology confirmed the diagnosis of telangiectatic granuloma. In all cases treatment was exclusively surgical. Conclusions: it is important for dental professionals to be aware of every single detail concerning telangiectatic granuloma, such as its clinical and histological characteristics and etiological factors, to be able to reach an accurate diagnosis and apply the appropriate therapy(AU)

Granuloma telangiectásico bucal / Oral telangiectatic granuloma

Introducción: el granuloma telangiectásico es un tumor reactivo inflamatorio en la cavidad bucal a causa de factores irritativos, traumafísico o factores hormonales. Es más frecuente en el sexo femenino entre la segunda y sexta décadas de la vida. Objetivo: describir los hallazgos clínico-patológicos del granuloma telangiectásico bucal, su posible patogénesis, diagnóstico diferencial y manejo terapéutico. Presentación de casos: se obtuvieron los datos de edad, género y diagnóstico clínico de una serie de cinco casos de granuloma telangiectásico bucal diagnosticados en la Facultad de Odontología de la Universidad de Cartagena entre el año 2016 y 2017. Se describen características clínicas, histológicas, factores etiológicos y sintomatología presentada en cada uno de ellos. El diagnóstico se realizó mediante histopatología y se confirmó como granuloma telangiectásico. En la totalidad de los casos el tratamiento realizado fue netamente quirúrgico. Conclusiones: es importante que los profesionales en odontología conozcan todos y cada uno de los aspectos relacionados con el granuloma telangiectásico, características clínicas, histológicas y los factores etiológicos, con el objeto de poder ofrecer un diagnóstico certero y, por consiguiente, un adecuado plan de tratamiento(AU)

Introduction: telangiectatic granuloma is an inflammatory reactive tumor of the oral cavity caused by irritating agents, physical trauma or hormonal factors. It is more frequent in the female sex between the second and sixth decades of life. Objective: describe the clinical-pathological findings of oral telangiectatic granuloma, as well as its possible pathogenesis, differential diagnosis and therapeutic management. Case presentation: data were obtained about the age, sex and clinical diagnosis of a series of five cases of oral telangiectatic granuloma diagnosed at the School of Dentistry of the University of Cartagena in the period 2016-2017. A description is provided of clinical and histological characteristics, etiological factors and symptoms of each case. Histopathology confirmed the diagnosis of telangiectatic granuloma. In all cases treatment was exclusively surgical. Conclusions: it is important for dental professionals to be aware of every single detail concerning telangiectatic granuloma, such as its clinical and histological characteristics and etiological factors, to be able to reach an accurate diagnosis and apply the appropriate therapy(AU)

An update of 77 cases diagnosed as oral hemangiomas based on GLUT-1 positivity.

OBJECTIVES: To evaluate cases diagnosed as "oral hemangiomas" based on the immunohistochemical expression of human glucose transporter protein (GLUT-1) and on histopathological features, and to investigate whether the classification proposed by the ISSVA was used correctly to classify these lesions. MATERIAL AND METHODS: All cases stored in the archives of an Oral Pathology Service and diagnosed as "oral hemangiomas" were reviewed. Seventy-seven cases were analyzed regarding the expression of GLUT-1. GLUT-1(+) specimens were classified as true infantile hemangioma (IH) and GLUT-1(-) specimens were reclassified based on their histopathological features. The nomenclature of these lesions was evaluated and some cases were reclassified. RESULTS: Only 26 (33.8%) of the specimens were indeed IHs. Among the GLUT-1(-) specimens, 20 (26.0%) were reclassified as pyogenic granulomas (PGs) and 31 (40.2%) as vascular malformations. Considering the previously applied nomenclature, only 47.5% of the cases initially diagnosed as "hemangiomas" were IHs. In the group of "capillary hemangiomas", most cases (56.2%) were PGs. Among the three "cellular hemangiomas", two were PGs and one was IH. Most (88.8%) "cavernous hemangiomas" were vascular malformations. CONCLUSION: Careful and parameterized review of cases of vascular anomalies is necessary using auxiliary tools such as GLUT-1, since the exclusive use of histopathological findings might be insufficient to differentiate some anomalies. CLINICAL RELEVANCE: Accurate clinical examination and the use of biomarkers such as GLUT-1 are essential for the diagnosis.

Oral Adenosquamous Carcinoma Mimicking a Pyogenic Granuloma: a Challenging Diagnosis.

Adenosquamous carcinoma is an aggressive variant of squamous cell carcinoma. This report describes a case of adenosquamous carcinoma with clinical features of a benign lesion and discusses the differential diagnoses, especially regarding histopathological and immunohistochemical analyses. A 45-year-old male was referred to our outpatient clinic complaining about a rapid-growing enlargement in hard palate. Clinical examination revealed an erythematous and pedunculated nodule with lobulated non-ulcerated surface. Excisional biopsy was performed following clinical diagnosis of pyogenic granuloma. Histologically, the specimen consisted of areas characterizing both well-differentiated squamous cell carcinoma and true adenocarcinoma. After a broad list of immunohistochemical markers was evaluated (AE1/AE3, CEA, CK5, CK7, CK8/18, p53, p63 and Ki67), the diagnosis of adenosquamous carcinoma was rendered and the patient referred to complementary surgery. Adenosquamous carcinoma represents a challenge in diagnostic routine due to its rarity, diverse range of clinical presentations and histological features. Furthermore, classical clinical benign features may be present in malignant lesions; hence the submission of every surgical specimen to histological analysis is mandatory to provide the patient the adequate treatment.