Diagnostic Challenges of Pyogenic Granuloma: A Retrospective Review
Background: Pyogenic granuloma (PG) is a benign, hyperplastic vascular lesion frequently found in the oral cavity. It often mimics other lesions such as peripheral giant cell granuloma and hemangioma, making clinical diagnosis challenging. Accurate diagnosis is essential to avoid mismanagement, emphasizing the need for histopathological examination. This study aims to retrospectively analyze the clinical and histopathological features of PG, highlighting the diagnostic challenges in distinguishing it from other similar oral lesions.
Materials and Methods: A retrospective review of 70 cases of PG diagnosed between 2017 and 2024 was conducted. Data collected included patient demographics, clinical presentation, provisional diagnosis, histopathological findings, and treatment modalities. Cases were categorized based on provisional and histopathological diagnoses, and descriptive statistics were applied.
Results: PG was most prevalent in the 31-40-year age group (27.1%). The mandibular alveolar mucosa was the most common site (54%). Only 38.6% of cases provisionally diagnosed as PG were histopathologically confirmed, while 38.6% were misdiagnosed. 22.9% of cases provisionally diagnosed as other lesions were confirmed as PG. Excisional biopsy was performed in 87.1% of cases, while incisional biopsy was used in larger or more suspicious lesions (12.9%).
Conclusion: PG poses significant diagnostic challenges due to its clinical similarity to other lesions. Histopathological confirmation is crucial for accurate diagnosis. Excisional biopsy is the preferred treatment, with incisional biopsy reserved for larger lesions or where malignancy is suspected. Careful diagnosis and management are essential to reduce recurrence and ensure optimal patient outcomes.
Keywords: Pyogenic granuloma, histopathological diagnosis, excisional biopsy, diagnostic challenges, oral lesions.
