Idiopathic huge pyogenic granuloma in young and old: An unusually large lesion in two cases
A 70-year-old female patient reported with a chief complaint of mass in the gums of lower left posterior region of the jaw since 36 months. The lesion was painless, but presented a significant discomfort in mastication due to its size. The mass was gradually increasing in size. No history of any other systemic disease was present. On clinical examination, localized exophytic mass with pedunculated base was observed on lingual gingiva measuring about 7 × 4 cm in size, extending from 34 to 38 region []. The surface was smooth. Physical examination revealed no other abnormalities or cervical lymphadenopathy. Teeth in relation to the lesion were mobile. Oral hygiene was poor and severe halitosis was noticed.\nOrthopantomogram was taken preoperatively [].\nSurgical excision was planned for both the cases under general anesthesia, due to their extensive nature. After placement of Ryle's tube and nasal intubation, lignocaine 2% with 1:200,000 adrenaline was infiltrated at margins of the lesion. Pedunculated stalk was excised with help of a 15 no. B.P. blade and electrocautery. The mass, in both the cases, were extending interdentally. Thus, in order to avoid leaving any remnants of the lesion interdentally, the teeth involved were extracted and alveolar process trimmed. Hemostasis was achieved using electrocautery and Surgical. Primary closure was achieved. Antibiotics and analgesics were prescribed for 1 week. The excised tissue was sent for histological examination [Figures and ]. Patient was instructed to feed through Ryle's tube for 4 days. Wound healed without any complications. Patient was followed-up for 6 months, no recurrence was observed till date.