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

Abstract

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.

Numerous Angiomatous Lesions in an Infant

“…1 To our knowledge, only 13 cases of CDPG are documented in medical literature. [1][2][3][4] The histopathologic findings indicative of CDPG show capillary proliferation with enlarged endothelial nuclei and highly vascular granulation tissue. Diagnosis is confirmed by positive CD31 and negative GLUT-1 and D2-40 staining.…”

Infantile hemangioma

“…The most frequent differential diagnosis includes vascular malformations, congenital hemangioma, pyogenic granuloma, or Kaposiform hemangioendothelioma [30,[42][43][44].…”

“…Typically PG appears after minor trauma as exophytic, vascular papules with a diameter between 1 and 10 mm. Most commonly PG is located on the face and neck, and may bleed easily [30,43].…”

“…diAgnostykA różnicoWA W diagnostyce różnicowej należy uwzględnić przede wszystkim nieprawidłowości naczyń, naczyniaki wrodzone, ziarniniaki naczyniowe oraz naczyniakośródbłoniaki o typie mięsaka Kaposiego (Kaposiform hemangioendothelioma) [30,[42][43][44].…”

“…Ziarniniaki naczyniowe zazwyczaj rozwijają się w miejscu drobnego urazu jako egzofityczne guzki o średnicy od 1 do 10 mm. Większość PG jest zlokalizowanych na twarzy oraz szyi, często krwawi [30,43].…”