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PubMed2003

Intravenous pyogenic granuloma of the hand.

BACKGROUND: Intravenous pyogenic granuloma is the intravasal counterpart of cutaneous pyogenic granuloma. This rare, benign lesion appears clinically as a subcutaneous nodule usually located in the upper extremity or neck in middle-aged people. It is hard to make an exact diagnosis on clinical basis, and there is a risk of recurrence because of undertreatment. OBJECTIVE: To report a case of an intravenous pyogenic granuloma located in the hand and to describe the clinical and histopathologic features of this rare vascular tumor. METHODS: An operation was performed on a 58-year-old female who presented with a small, painless mass in the right palm, and the pathologic examination revealed an intravenous pyogenic granuloma. CONCLUSION: This rare lesion should be differentiated from a regular pyogenic granuloma and should be excised with the vein segment to avoid recurrence.

Female↗
PubMed2001

Treatment of pyogenic granuloma with a sclerosing agent.

BACKGROUND: Pyogenic granulomas have been treated by cryosurgery, curettage, electrodesiccation, chemical cauterization, and laser surgery. The therapeutic effects of these conservative treatments are limited, however. OBJECTIVE: In this study, the efficacy of a sclerosing agent (monoethanolamine oleate) was evaluated for the treatment of pyogenic granuloma. METHODS: Pyogenic granuloma was treated by local injection of the monoethanolamine oleate solution in nine patients who were from 1 to 57 years of age (median 18 years). The treatment effect was determined by physical examination. RESULTS: All lesions were removed completely with no recurrence, and scars were inconspicuous in all cases. Complications occurred in only one patient who complained of pain due to an avoidable injection of excess solution. CONCLUSION: Sclerotherapy with monoethanolamine oleate is effective in the treatment of pyogenic granuloma and offers an alternative to conventional methods in cases for which conservative treatment is preferable.

Adolescent↗
PubMedDate not supplied

Intravenous pyogenic granuloma: immunohistochemical consideration--a case report.

Intravenous pyogenic granuloma is a rare form of pyogenic granuloma in which the whole lesion appears as a single polypoid mass projecting into the lumen of a vein. Histologically, this benign lesion is similar to pyogenic granuloma of other locations and is characterized by lobular proliferation of capillaries embedded in a fibromyxoid stroma. The following report illustrated the classic findings associated with an intravenous pyogenic granuloma in a young woman. A brief review of this rare entity follows the case report. Although the history and physical findings were approximately the same in each patient, they do not seem characteristic enough to allow for a definite preoperative diagnosis. The clinical differential diagnosis of intravenous pyogenic granuloma is varied and requires careful pathologic attention if excised. Complete local excision with a small portion of the vein is the treatment of choice.

Adult↗
PubMed1994

Identification and semiquantification of estrogen and progesterone receptors in pyogenic granulomas of pregnancy.

Cases of pyogenic granuloma in pregnant women, nonpregnant women, and men were evaluated for the detection of estrogen and progesterone receptor proteins by immunoperoxidase staining. Immunostaining for estrogen receptors revealed a marked immunoreactivity of the endothelium within lesional tissue and in the overlying mucosal epithelium in many cases. Progesterone receptor immunoreactivity was only present within the epithelium, where it was much less than that of estrogen receptor immunoreactivity in both quantity (proportion of positive cells) and intensity. No characteristic staining pattern or significant quantitative difference among the three study groups could be discerned. These findings suggest that the quantity of estrogen or progesterone receptors in pyogenic granuloma is not the determining factor in the pathogenesis of this lesion. Rather, such a role may be attributed to the levels of circulating hormones. The levels of estrogen and progesterone are markedly increased in pregnancy and could therefore exert a greater effect on the endothelium of the pyogenic granuloma.

Adolescent↗
PubMed1998

Pyogenic granuloma of the cornea.

BACKGROUND: Ocular pyogenic granulomata are uncommon and are often associated with a chalazion or previous ocular and adnexal surgery The avascular nature of the cornea may explain the rarity of pyogenic granulomata at this site. We report on a case of corneal pyogenic granuloma following previous corneal surgery. METHODS: Ophthalmologists who had treated the patient previously were contacted and earlier clinical notes and histopathological examinations were reviewed. The clinical course following excision of the pyogenic granuloma is described, as are the histopathological findings. RESULTS: Histological examination confirmed the diagnosis of pyogenic granuloma. Excision was followed by a clinical recurrence at a different site with spontaneous resolution. CONCLUSIONS: Pyogenic granulomata of the cornea are rare. However, the present case illustrates the importance of considering benign inflammatory causes in the differential diagnosis of a corneal mass lesion so as to avoid unnecessarily aggressive intervention. To our knowledge, spontaneous resolution of a corneal pyogenic granuloma has not been previously described.

Aged↗
PubMed2000

Multiple, genital lobular capillary haemangioma (pyogenic granuloma) in a young woman: a diagnostic puzzle.

A 21 year old woman presented with multiple lobulated lesions on the labia majora. The surface of most of the lesions was ulcerated revealing a glistening surface. All lesions were excised. The histopathology revealed features suggestive of lobular capillary haemangioma (pyogenic granuloma). Pyogenic granuloma is considered as a reactive hyperproliferative vascular response to trauma or other stimuli. A literature search revealed reports of a few cases of lobular capillary haemangioma of the glans penis but not on the female genitalia. This case is presented to help physicians become aware that lobular capillary haemangiomas (pyogenic granuloma) may occur at this site.

Adult↗
PubMed1994

Reliable treatment of pyogenic granuloma of the hand.

Pyogenic granuloma (PG) is a common skin tumour whose aetiology is unknown. There is a significant recurrence rate whatever method of treatment is used, and there are many studies in the literature on the treatment of recurrence. In our experience, the most effective way of preventing recurrence is the complete removal of the tumour using the microscope, operating in a bloodless field. Only then can the whole tumour with its supply vessels be reliably removed. 20 cases of PG on the hand, three cases in the shoulder-neck area and one case on the foot have been treated in our department over a period of 4 years. Five of these were recurrences and all involved the hand. Three of these were infected. 17 patients were followed for 3 months to 3.5 years. There were no recurrences in these patients, all of whom were operated on using the method described above.

Adolescent↗
PubMed1996

Large pyogenic granuloma: a case report.

Pyogenic granuloma is a common reactive lesion seen in the third decade of life, generally between 1 and 2 cm in size. It may be confused clinically with malignancy. It is treated by surgical excision, and recurrence is rare.

Adolescent↗
PubMed1998

Pyogenic granuloma of the scrotum.

Pyogenic granuloma is a benign, vascular, over-exuberant, inflammatory, solitary skin tumor common in infants and children. It is a rapidly growing solitary, sessile, or polypoidal vascular nodule that will bleed easily. The exact pathogenesis of this condition is unknown. Various predisposing factors, such as trauma, hormones, infection, viral oncogenesis, microscopic anastomosis, and others may be responsible for its growth.

Adolescent↗
PubMed1991

[Study of pyogenic granuloma of the oral cavity].

Pyogenic granuloma is one of the diseases sometimes seen in otorhinolaryngology clinics. The clinical features of this disease are understood to be that the lesion is located in the oral cavity in the majority of cases that its causative agent is usually discovered and that it most likely grows as a malignant tumor. However, the entity of pathological diagnosis has not been established. Thirty-one cases of oral pyogenic granuloma, including 16 males and 15 females, are reported in this paper. The granuloma was located most frequently at the tongue, followed, in order, by the gingiva, buccal mucosa, hard palate, lip and oral floor. The period between the patient's first visit to our clinic and the onset of his/her complaint was variable. It was relatively shorter in those cases with the lesion at the gingiva or tongue as compared to other locations. The size of the lesion was smaller than 10 x 10 mm. We classified the pathological features into three patterns; granuloma type, hemangioma type, and intermediate type. Many cases of lesions located at the back of the tongue, buccal mucosa, or hard palate were of the hemangioma type, while many cases of lesions located at the top of the tongue, gingiva, or oral floor were of the granuloma type. We have the impression that pyogenic granuloma could be one of the purulent changes associated with benign oral tumors.

Adolescent↗
PubMed2005

Conjunctival pyogenic granulomas after strabismus surgery.

PURPOSE: To measure the incidence and evaluate treatment of pyogenic granulomas after strabismus surgery. DESIGN: Retrospective observational case series. PARTICIPANTS: Four hundred seventy-nine strabismus surgical patients. METHODS: Incidence was determined by review of 472 consecutive patients who underwent strabismus surgery from January 6, 1999 to December 29, 2000. Outcomes were evaluated in 7 additional patients who underwent surgical excision of pyogenic granulomas over a 6-year period from July 5, 1995 to September 19, 2001 (exclusive of the years 1999-2000). MAIN OUTCOME MEASURE: Development and resolution of pyogenic granulomas. RESULTS: Pyogenic granulomas developed in 10 of 472 patients (2.1%). None of these patients had more than 1 pyogenic granuloma, despite having had surgery before or after the event. Treatment of pyogenic granulomas with topical corticosteroids was successful in 90% of patients. Surgical excision was successful in the group of 7 additional patients who did not respond to corticosteroids. CONCLUSIONS: Conjunctival pyogenic granulomas are a potential complication of strabismus surgery. Treatment with topical steroids is an effective initial treatment for most patients with pyogenic granulomas. Surgical excision is effective in patients who do not improve with topical medication. Patients with multiple surgeries do not seem to be at increased risk for pyogenic granulomas, and the occurrence of a pyogenic granuloma does not seem to increase the risk of developing pyogenic granulomas in future surgeries.

Child↗
PubMed1992

Pitfalls in the histopathologic diagnosis of pyogenic granuloma.

The term pyogenic granuloma (PG) is a misnomer. The histopathologic appearance is fairly characteristic, the lesion being in fact a lobular capillary hemangioma. The recognition of PG as a clinically polypoid or exophytic, circumscribed lesion is of importance to both the clinician and the pathologist, as this feature distinguishes PG from most malignant vascular tumors. Although PG may be multiple, especially on the skin, and necrosis is not uncommon, invasion of adjacent structures is not seen. Diagnostic pitfalls occur histologically when the characteristic lobular configuration of PG is not recognized because of a solid growth pattern of endothelial proliferation, the presence of brisk mitosis, intervascular stromal fibrosis or spindle cell proliferation, and occasionally an epithelioid appearance of endothelial cells. The different vascular neoplasms that may be confused with PG are discussed, and the clinical and histopathologic features of PG are emphasized.

Angiolymphoid Hyperplasia with Eosinophilia↗
PubMed2003

Pediatric pyogenic granuloma of the glans penis.

Pyogenic granulomas are benign vascular proliferations of the skin and mucous membranes. We present a case report of a 13-year-old uncircumcised boy with phimosis and a pyogenic granuloma of the glans penis. The relationship between these lesions, phimosis, smegma, and circumcision is discussed. When the lesion is found in conjunction with phimosis, consideration should be given for circumcision. Close follow-up to rule out recurrence is necessary.

Adolescent↗
PubMed2004

Pyogenic granuloma arising within a port-wine stain.

Pyogenic granulomas are common overgrowths of vascular tissue that usually arise on the face, lips, or hands after episodes of minor trauma or during pregnancy. Pyogenic granulomas rarely have been reported to arise in congenital capillary malformations such as port-wine stains, a presentation that most often occurs after laser treatment of port-wine stains or in the setting of pregnancy. This co-occurrence of the 2 lesions represents an underreported event, and the presentation can be alarming or mimic malignancy when there is no prior history of trauma or other known circumstances in which pyogenic granulomas occur. We report a case of a pyogenic granuloma emerging within a port-wine stain in a 35-year-old man with no predisposing factors. A review of the literature regarding pyogenic granulomas that arise within port-wine stains is presented and yields informative conclusions regarding the clinical scenarios where this sometimes alarming event is likely to happen.

Adult↗
PubMed2004

Pyogenic granuloma: an unrecognized cause of gastrointestinal bleeding.

Pyogenic granuloma is a lobular capillary hemangioma that mostly occurs on the skin, but it is also encountered on the mucosal surface of the oral cavity. Only a few cases in other parts of the digestive tract have been reported in Japanese patients. In this report, two Caucasian patients are described, who presented with gastrointestinal bleeding due to the presence of a pyogenic granuloma. One was located in the distal esophagus and could be treated with local excision and laser-photocoagulation therapy. The other one was located in the small intestine and was removed by surgical resection. Although extremely rare, pyogenic granuloma as a cause of gastrointestinal bleeding needs consideration. The lesion is benign, presumably reactive and can be adequately treated by excision or laser photocoagulation. Immunohistochemistry and/or polymerase chain reaction for herpesvirus 8 can reliably distinguish pyogenic granuloma from Kaposi's sarcoma, an important differential diagnosis.

Diagnosis, Differential↗
PubMed2001

Pyogenic granuloma following oculoplastic procedures: an imbalance in angiogenesis regulation?

BACKGROUND: Pyogenic granuloma is a vasoproliferative inflammatory response composed of granulation tissue. The pathogenesis is not entirely clear. We describe a series of patients with pyogenic granulomas occurring following common oculoplastic procedures and propose a common etiology. METHODS: Sixteen cases of pyogenic granuloma that occurred after various oculoplastic procedures from 1991 to 2000 were collected from the files of two oculoplastic surgeons. RESULTS: Pyogenic granulomas were found to occur at surgical and nonsurgical sites associated with tissue irritation or inflammation or both. INTERPRETATION: Capillaries are a predominant component of wound healing and pyogenic granulomas. The growth and development of new capillaries follows an orderly sequence of events that is highly regulated by a variety of angiogenic factors. We postulate an imbalance in angiogenesis regulation as the common pathway for pyogenic granuloma development.

Adolescent↗
PubMed2005

Pyogenic granulomas after silicone punctal plugs: a clinical and histopathologic study.

PURPOSE: To describe clinical findings, histopathologic changes, and risk factors for pyogenic granuloma formation complicating silicone punctal plug therapy. DESIGN: Retrospective observational case series. METHODS: Between November 2000 and April 2004, 903 silicone punctal plugs of the same brand were inserted in 404 subjects. Cases associated with pyogenic granuloma formation were identified and reviewed. Granulation tissue was obtained from 10 patients for histopathologic examination. Multiple risk regression analyses identified factors related to pyogenic granuloma development and factors associated with histologic patterns. RESULTS: Pyogenic granuloma development led to the extrusion of 4.2% of all plugs placed in a median time period of 141 days. All patients presented with varying degrees of plug extrusion. Similar distributions of partial and complete plug extrusions, as well as bilateral and unilateral plug extrusions, were seen. Findings at presentation ranged from a subclinical pyogenic granuloma causing partial plug extrusion to a pyogenic granuloma in the punctum with a ring of fibrovascular tissue retaining a completely extruded plug. Histopathologic examination revealed two patterns, representing either acute pyogenic granuloma or involuting pyogenic granuloma. Pyogenic granulomas resolved after 3.1 +/- 1.3 weeks in all patients after plug removal. Multiple regression analysis revealed that large plug size was associated with increased pyogenic granuloma formation (P < .0001). Partial or complete plug extrusion was associated with active or involuting pyogenic granuloma, respectively (P = .023). CONCLUSION: Pyogenic granuloma-related spontaneous plug extrusions may be more common than previously thought and can present with a range of clinical findings. The degree of plug extrusion correlates with the histopathologic pattern. Larger plug size and sharp edges in plug geometry may be responsible for pyogenic granuloma formation.

Adult↗