Lobular capillary hemangioma (LCH), also called pyogenic granuloma, is a benign vascular tumor that is pedunculated on the skin and the mucous membranes of the oral cavity. This disease occurs in all ages, but more often in the 3rd decade, and is seen in females more than males. LCH commonly appears in early childhood and affects males more than females in the pediatric age group. The gingiva, lips, tongue and buccal mucosa are the most common sites of mucosal LCH, but the nasal cavity is rare. Micro-trauma and hormonal factors are the most common etiologic factors. Epistaxis and nasal obstruction are the most marked symptoms. We describe the case of a 6-year-old girl with intra-nasal lobular capillary hemangioma presented with epistaxis and nasal obstruction. This should be considered in the differential diagnosis of childhood endonasal masses with bleeding. Total excision using endoscopic technique is the treatment of choice.
Actinomycosis is a rare chronic infectious disease caused by Actinomyces israelii, which is an anaerobic filamentous, gram-positive saprophyte organism of the oral cavity. Historically, these bacteria were known as fungi because of their light microscopic appearance. Actinomycosis consists of three different forms: cervico-facial (the most common form), abdominal and pulmonothoracic. It commonly involves the head and neck region including the mandible, paranasal sinuses, lacrimal gland, parotid gland and orbit. Poor oral hygiene and dental diseases have been known to be the source of actinomycosis. Actinomycosis is diagnosed with positive culture or detecting actinomyces colonies and sulfur granules in histopathologic specimens. The treatment of choice is surgical excision of the lesion and long-term penicillin therapy. Actinomycosis of the internal nose is extremely rare. There was only one nasal septum actinomycosis reported in the English literature, but there was no lateral nasal wall actiomycosis regarding the turbinate. Therefore, actinomycosis should not be overlooked for the differential diagnosis of intra-nasal lesions for the initiation of appropriate and early treatment.
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