Giant lingual granuloma gravidarum

Oral pyogenic granuloma presenting as an atypically large soft tissue mass: A case report

“…Most reports suggest that PGs grow to a maximum size of 2 cm while lesions of larger size called "Giant pyogenic granuloma" were reported extraorally with the size larger than 4 cm [2,5,7]. In addition, there were few reports of intraoral PG with the size larger than 2 cm [8][9][10][11]. Therefore, we report this unusually large size of oral PG on the right lower gum in an elderly female patient.…”

“…However, three cases of intraoral giant PG reported by Tzung-Shiahn et al [10], Mubeen et al [11] and Panjwani et al [9] were not associated with host's immunity [9][10][11]. Recently, there was a report of intraoral giant PG size 4 cm × 3 cm in pregnancy woman with decreasing in size after her delivery [8].…”

“…Complete excision and improvement of patients' oral hygiene are necessary for effective treatment. Regular oral health care and continuous follow-up are required to prevent recurrence of the lesion [2,3,5,6,[8][9][10][11][12].…”

Initial periodontal therapy for the treatment of gingival pregnancy tumor

“…In addition, estrogen is able to enhance the generation of vascular endothelial growth factor (VEGF) in macrophages, which is antagonized by androgens and probably correlates with the development of pyogenic granuloma during pregnancy (Kanda and Watanabe, 2005). Progesterone functions as an immunosuppressant in the gingival tissue of pregnant women, preventing a rapid acute inflammatory reaction against plaque, but allowing for increased chronic tissue reaction and resulting in exaggerated inflammation (Durairaj et al, 2011). Lastly, during pregnancy, female sex hormones induce clinico-microbiological changes, particularly an increased number of the periodontal pathogens Porphyromonas gingivalis and Prevotella intermedia, that affect the target cells, including keratinocytes and fibroblasts, in the gingiva (Carrillo-de-Albornoz et al, 2010).…”

“…Approximately 75% of oral pyogenic granuloma occurs in the gingiva (Brosens et al, 2015). It occurs in populations of all ages, but is frequently encountered in females in their 20s due to the increased levels of circulating hormones, such as estrogen and progesterone (Durairaj et al, 2011). Hence, the terms "pregnancy tumor" and "granuloma gravidarum" are widely employed (Neville et al, 2002).…”