A giant pyogenic granuloma gravidarum in the nasal cavity: A case report

Abstract

Pyogenic granuloma (PG) is a benign fibrovascular proliferative lesion on the skin and mucous membranes, but its pathogenesis remains unclear. PG usually occurs on the head and neck region, fingers and toes. The oral gingiva is the most common location for pregnant patients, while it is rarely found in the nasal cavity. This case is notable not only for its uncommon site and size but also for its gradual growth after delivery. Endoscopic surgery can achieve the desired cosmetic effect and a satisfactory airway. A rapidly growing hemorrhagic lesion in the nasal cavity should be considered as a differential diagnosis.

Pyogenic Granuloma Gravidarum of the Nasal Cavity Causing Recurrent Epistaxis. A Case Report and Review of the Literature

“…Another theory that has been proposed suggests that progesterone and estrogen receptors are transiently expressed in an early phase of the development of these lesions (4,22). Also, progesterone regulates the VEGF-A-VEGFR2 signaling, which is a promoter of angiogenesis and elevated levels might cause an imbalance of promoters and inhibitors during the angiogenic process (23). In our case, the patient was pregnant and had a history of nose piercing that could probably be related to chronic local trauma.…”

“…In our patient, recurrent episodes of anterior epistaxis were the main symptom. On endoscopic examination, pyogenic granuloma appears as a gray-to-pink, red or dark, irregular and hypervascularized tumor with a pedunculated base (16,23). Usually, these lesions are small, but giant lesions have also been described in the literature (17,23).…”

Otolaryngology and the Pregnant Patient

“…While these conditions generally resolve without intervention during puerperium, excision may be required for severe symptoms or lesions that persist after delivery. [27][28][29] Skull Base Pathology…”

“…While these conditions generally resolve without intervention during puerperium, excision may be required for severe symptoms or lesions that persist after delivery. [27][28][29] Skull Base Pathology Meningiomas and schwannomas are the most common benign skull base tumors to occur during pregnancy, though their incidence does not seem higher in pregnant patients than in matched nonpregnant populations. Meningiomas comprise 13% of central nervous system tumors diagnosed during pregnancy.…”

“…Nasal pyogenic granulomas typically present with epistaxis and unilateral nasal congestion. While these conditions generally resolve without intervention during puerperium, excision may be required for severe symptoms or lesions that persist after delivery …”