Pyogenic Granuloma of the Duodenum Treated Successfully by Endoscopic Mucosal Resection

Park, Seon-Young; Park, Chang-Hwan; Lee, Wan‐Sik; Kim, Hyunsoo; Choi, Sung‐Kyu; Rew, Jong Sun

doi:10.5009/gnl.2009.3.1.48

Cited by 14 publications

(11 citation statements)

References 13 publications

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“…6,7 On the basis of its distribution in the liver, hemangioma can be classified as focal, multifocal, or diffuse. 6,[8][9][10][11][12][13][14] Capillary hemangioma is composed of a lobular proliferation of vascular channels with plump endothelial cells lining the vascular channels. Capillary hemangioma, including lobular capillary hemangioma (also known as pyogenic granuloma), commonly presents on the skin and mucosa, although rare liver or gastrointestinal tract examples have been reported.…”

Section: Discussionmentioning

confidence: 99%

Anastomosing Hemangioma of the Liver and Gastrointestinal Tract

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Ulbright

et al. 2013

American Journal of Surgical Pathology

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Anastomosing hemangioma, a benign vascular neoplasm histologically simulating angiosarcoma, is newly recognized and has been described primarily in the genitourinary tract. We have encountered this lesion in the liver and gastrointestinal tract, where it can be diagnostically challenging, especially in core biopsy. Herein, we described 6 cases of anastomosing hemangioma of the liver and gastrointestinal tract. They occurred in 4 women and 2 men, ranging in age from 48 to 71 years. The tumors ranged from 0.2 to 6 cm (median, 3.1 cm) and were grossly well demarcated with a gray-brown spongy appearance. Microscopically, they had a loosely lobulated architecture. At higher magnification, lesions consisted of anastomosing sinusoidal capillary-sized vessels with scattered hobnail endothelial cells. Mild cytologic atypia occurred in all cases. Mitoses were absent. Vascular thrombi were seen in 4 cases (66.7%) without necrosis. One tumor (16.7%) featured prominent extramedullary hematopoiesis and 1 (16.7%) hyaline globules. Immunohistochemistry results were available for 3 cases, and the lesions stained with CD34 and/or CD31. Five cases had clinical follow-up information; there were no recurrences or metastases (range, 8 to 96 mo; mean, 41 mo), and 1 patient received no follow-up after a benign diagnosis on her colon polyp. In summary, anastomosing hemangioma of the liver and gastrointestinal tract is a rare distinctive vascular neoplasm displaying overlapping features with well-differentiated angiosarcoma. Despite small numbers and limited follow-up information in our series, evidence to date supports that the lesion is benign. Awareness of this entity is essential to avoid overdiagnosis and unnecessary aggressive treatment.

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Section: Discussionmentioning

confidence: 99%

Anastomosing Hemangioma of the Liver and Gastrointestinal Tract

Bigge

Ulbright

et al. 2013

American Journal of Surgical Pathology

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“…To our knowledge, approximately 65 cases of PG in the alimentary tract (other than in the oral mucosa) have been published in the literature. The reports have described 19 cases of PG in the esophagus [10–14]; five cases in the stomach; 20 cases in the small intestine [10,11,14–18]; 19 cases in the colon [10,19–25]; one case in an unidentified area of the alimentary tract [26]; and one case in the common bile duct [1]. The patients' ages ranged from 1.5 years to 82 years (mean age, 49.97 years) and 56.36% of the patients were male.…”

Section: Discussionmentioning

confidence: 99%

“…Complete excision is reportedly the optimal management for GI tract PG [4,29]. Endoscopic resection is the most favorable treatment for GI tract PG and has been reported in 63.33% of patients [3–7,10,12–19,21,23,24]. Only one patient developed perforation at the site of polypectomy and then underwent surgical repair; however, he recovered and was discharged 5 days later [23].…”

Section: Discussionmentioning

confidence: 99%

Clinical and endoscopic features of gastric pyogenic granuloma

Lin

Hsieh

Hsu

et al. 2014

Adv in Digestive Medicine

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Background: Pyogenic granuloma (PG) is a polypoid form of capillary hemangioma. This study aimed to analyze the clinical and endoscopic features of gastric PG. Methods: We retrospectively reviewed nine patients with gastric PGs who were evaluated by esophagogastroduodenoscopy and diagnosed by pathological study at the Chang Gung Medical Center (Taoyuan, Taiwan) between 2000 and 2009. Demographic data, clinical presentations, endoscopic findings, treatment, and outcome were collected and analyzed. Results: The median age of the study patients was 62 years (range, 40e73 years) with a female preponderance. The most common symptom at presentation was overt gastrointestinal bleeding, followed by anemia and epigastralgia. Two patients were asymptomatic at diagnosis. The most common underlying diseases were liver cirrhosis [5 (56%) patients] and hypertension [5 (56%) patients]. Five (56%) cases of gastric PGs originated at the site of prior ulcer lesions. Most gastric PGs were solitary [7 (78%) patients] and located in the antrum [8 (89%) patients]. The gastric PGs typically appeared morphologically as smooth protruding hyperemic lesions with adherent white or yellow deposits. One patient received an endoscopic mucosal resection with complete excision of the lesion. Another patient received surgical intervention. Four gastric PG lesions were stationary or regressed with conservative management. Conclusion: Overt gastrointestinal bleeding was the most common clinical presentation in patients with gastric PG. Gastric ulcers were the most common precursors of PG with the antrum being the most frequent site involved. Gastric PGs were characteristically protruding hyperemic lesions with adherent exudates. Conservative treatment may be considered for

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“…Only 42 cases of pyogenic granuloma in the alimentary tract have been reported to date; the granuloma was located in the esophagus in 23 of these cases 2-6. The incidence rate is the same regardless of the gender and age of the patient 4.…”

Section: Discussionmentioning

confidence: 99%

“…It is a benign inflammatory vascular lesion, mainly found in the skin and oral mucosa. Only a few cases of pyogenic granuloma in the gastrointestinal tract have been reported 2. A pyogenic granuloma is usually seen as a protruding polypoid lesion and occasionally as a submucosal tumor-like lesion on endoscopy.…”

Section: Introductionmentioning

confidence: 99%

Esophageal Pyogenic Granuloma: Endosonographic Findings and Endoscopic Treatments

et al. 2013

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Pyogenic granuloma is a benign inflammatory vascular lesion, mainly found in the skin and oral mucosa. A few cases of pyogenic granuloma in the gastrointestinal tract have been reported, and the esophagus was the main site in these cases. These patients were diagnosed with pyogenic granuloma after they underwent upper endoscopy and biopsy. Endoscopic resection is a favorable treatment option for esophageal pyogenic granuloma. Recently, we observed characteristic endosonographic findings in two cases with esophageal pyogenic granuloma, which were then treated successfully by endoscopic resection.

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Pyogenic Granuloma of the Duodenum Treated Successfully by Endoscopic Mucosal Resection

Cited by 14 publications

References 13 publications

Anastomosing Hemangioma of the Liver and Gastrointestinal Tract

Anastomosing Hemangioma of the Liver and Gastrointestinal Tract

Clinical and endoscopic features of gastric pyogenic granuloma

Esophageal Pyogenic Granuloma: Endosonographic Findings and Endoscopic Treatments

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