Pyogenic granuloma (PG) is a painless pedunculated granulomatous lesion that develops on the skin and mucous membranes. PG in children is relatively rare. We herein report a case of PG of the maxillary median gingiva in a pediatric patient. The patient was a 6-year-old Japanese boy who presented with a painless mass with bleeding after exfoliation of the left upper deciduous central incisor. The lesion had undergone continuous, rapid growth for approximately 10 days. Intraoral findings revealed a painless, elastic, soft, and non-pedunculated mass, measuring 15 × 10 mm, in the left upper deciduous central incisor area. To differentiate it from malignancy, an excisional biopsy was performed on the patient under general anesthesia. Histological findings confirmed that the patient suffered from PG. At the time of writing this paper, the patient had been clinically followed up for the 18th month after the surgery, showing no signs of tumor recurrence.

1. Angelopoulos AP. Pyogenic granuloma of the oral cavity: Statistical analysis of its clinical features. J Oral Surg. 1971;29(12):840-847.

2. Banjar A, Abdrabuh A, Al-Habshi M, Parambil M, Bastos P, Abed H. Labial pyogenic granuloma related to trauma: A case report and mini-review. Dent Traumatol. 2020;36(4):446-451. doi: 10.1111/edt.12537

3. Leyden JJ, Master GH. Oral cavity pyogenic granuloma. Arch Dermatol. 1973;108(2):226-228.

4. Willies-Jacobo LJ, Isaacs H Jr., Stein MT. Pyogenic granuloma presenting as a congenital epulis. Arch Pediatr Adolesc Med. 2000;154(6):603-605. doi: 10.1001/archpedi.154.6.603

5. Akyol MU, Yalçiner EG, Do?an AI. Pyogenic granuloma (lobular capillary hemangioma) of the tongue. Int J Pediatr Otorhinolaryngol. 2001;58(3):239-241. doi: 10.1016/s0165-5876(01)00425-6

6. Milano M, Flaitz CM, Bennett J. Pyogenic granuloma associated with aberrant tooth development. Tex Dent J. 2001;118(2):166-172.

7. Jurkiewicz BDZ. Rare case of pyogenic granuloma of the tongue in an 8-week-old infant. Eur Arch Otorhinolaryngol. 2005;262(6):453-455. doi: 10.1007/s00405-004-0845-6

8. Shenoy SS, Dinkar AD. Pyogenic granuloma associated with bone loss in an eight year old child: A case report. J Indian Soc Pedod Prev Dent. 2006;24(4):201-203. doi: 10.4103/0970-4388.28078

9. De Souza AG, da Silva BC, Israel MS, Lindenblatt R, de Andrade AM, Ramos ME. Atypical location of pyogenic granuloma in two pediatric patients. Gen Dent. 2008;56(5):447-450.

10. Das Chagas MS, Pinheiro RS, Janini ME, Maia LC. Pyogenic granuloma: Lobular capillary hemangioma in the upper lip of a 24-month-old child: Case report. J Dent Child (Chic). 2009;76(3):237-240.

11. Sulabha AN, Choudhary S, Suchitra G. Pyogenic granuloma associated with angular bone defect in young boy: An unusual case report. Int J Oral Maxillofac Pathol. 2012;3:49-52.

12. Ximenes M, Triches TC, Cardoso M, Bolan M. Pyogenic granuloma on the tongue: A pediatric case report. Gen Dent. 2013;61(5):27-29.

13. Lindsay H, Srivaths LV. Oral pyogenic granuloma in hemophilia: A report of 2 cases. J Pediatr Hematol Oncol. 2014;36(5):e333-e334. doi: 10.1097/mph.0000000000000155

14. Jain M, Singhal S, Goyal M, Sharma B. Pyogenic granuloma in eight-year-old child associated with bone loss and displacement of tooth bud: A unique case. Int J Exp Dent Sci. 2015;4(2):134-136. doi: 10.5005/jp-journals-10029-1112

15. Agarwal N, Kumar D, Vaish A, Anand A. A rare case of pyogenic granuloma with a natal tooth. J Clin Diagn Res. 2016;10(10):ZD28-ZD29. doi: 10.7860/jcdr/2016/23040.8701

16. Nirmala SVS, Vallepu R, Babu M, Dasarraju RK. Pyogenic granuloma in an 8 year old boy - A rare case report. J Pediatr Neonatal Care. 2016;4(2):00135. doi: 10.15406/jpnc.2016.04.00135

17. Cheney-Peters D, Lund TC. Oral pyogenic granuloma after bone marrow transplant in the pediatric/adolescent population: Report of 5 cases. J Pediatr Hematol Oncol. 2016;38(7):570-573. doi: 10.1097/mph.0000000000000593

18. Peters SM, Koslovsky DA, Yoon AJ, Philipone EM. Pyogenic granuloma in the tongue in a five year old: A case report. J Clin Pediatr Dent. 2018;42(5):383-385. doi: 10.17796/1053-4625-42.5.10

19. Lim CC, Sawali H, Ong CA, Nordin A, Liew YT. A recalcitrant huge pyogenic granuloma in a young child mimicking as lingual hemangioma. Medeniyet Med J. 2019;34(1):113-116. doi: 10.5222/mmj.2019.90236

20. Alaoui ML, Tabbai S, Benkarroum FZ, Chhoul H. Management of a pyogenic granuloma of the tongue: A case report and review of the literature. Int J Appl Dent Sci. 2019;5:107-110.

21. Agel M, Ahluwalia M. Unusual presentation of a pyogenic granuloma in a 6-Year-old child. Dent Update. 2020;47(2):149-152. doi: 10.12968/denu.2020.47.2.149

22. Ahsan Razi M, Debnath S, Qamar S, Tripathi A. Management of pyogenic granuloma in pediatric patients using electrocautery-Case reports. IP Int J Periodontol Implantol. 2020;4(4):141-146. doi: 10.18231/j.ijpi.2019.030

23. Tazegül F?, Bodrumlu EH. Hyperplastic lesion of the gingiva in an 8-year-old male with pyogenic granuloma: A case report. Int J Appl Dent Sci. 2020;6:296-298.

24. Tatar RT, Nacea DI, Enescu DM. Uncommon location of pyogenic granuloma in a child - Case report and mini-review. Arch Balk Med Union. 2020;55(4):696-703. doi: 10.31688/abmu.2020.55.4.18

25. Kavitha M, Prathima GS, Vinothini V, Vigneshwari SK. Recurrent episodes of oral pyogenic granuloma at different site in an 8-year-old girl: An unusual presentation. Int J Clin Pediatr Dent. 2021;14(5):730-733. doi: 10.5005/jp-journals-10005-2033

26. Nassar MM, Besar OFA. Pyogenic granuloma of tongue in a 10-year-old child - A case report. Egypt J Ear Nose Throat Allied Sci. 2022;23(23):1-4. doi: 10.21608/ejentas.2022.111841.1449

27. Gera D, Tanwar A, Nigam AG, Jain S, Sharma V. Pyogenic granuloma in a 6-year-old boy - A rare case report. Int J Contemp Pediatr. 2023;10(4):607-610. doi: 10.18203/2349-3291.ijcp20230749

28. Jafarzadeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: A review. J Oral Sci. 2006;48(4):167-175. doi: 10.2334/josnusd.48.167

29. Lee L, Miller PA, Maxymiw WG, Messner HA, Rotstein LE. Intraoral pyogenic granuloma after allogeneic bone marrow transplant. Report of three cases. Oral Surg Oral Med Oral Pathol. 1994;78(5):607-610. doi: 10.1016/0030-4220(94)90173-2

30. Woo SB, Allen CM, Orden A, Porter D, Antin JH. Non-gingival soft tissue growths after allogeneic marrow transplantation. Bone Marrow Transplant. 1996;17(6):1127-1132.

31. Al-Mohaya M, Treister N, Al-Khadra O, Lehmann L, Padwa B, Woo SB. Calcineurin inhibitor-associated oral inflammatory polyps after transplantation. J Oral Pathol Med. 2007;36(9):570-574. doi: 10.1111/j.1600-0714.2007.00557.x

32. De la Rosa García E, Bologna Molina R, Vega González TJ. Graft-versus-host disease, an eight case report and literature review. Med Oral Patol Oral Cir Bucal. 2006;11(6):E486-E492.

33. Suh JD, Blackwell KE, Nabili V. Graft-versus-host disease of the tongue. Otolaryngol Head Neck Surg. 2009;140(2):272-273. doi: 10.1016/j.otohns.2008.10.015

34. Balasubramaniam R, Alawi F, DeRossi S. Superficial mucoceles in chronic graft-versus-host disease: A case report and review of the literature. Gen Dent. 2009;57(1):82-88.

35. Wassef M, Blei F, Adams D, et al. Vascular anomalies classification: Recommendations from the international society for the study of vascular anomalies. Pediatrics. 2015;136(1):e203-e214. doi: 10.1542/peds.2014-3673

36. Epivatianos A, Antoniades D, Zaraboukas T, et al. Pyogenic granuloma of the oral cavity: Comparative study of its clinicopathological and immunohistochemical features. Pathol Int. 2005;55(7):391-397. doi: 10.1111/j.1440-1827.2005.01843.x

37. Kawachi N. A Comparative histopathological and immunohistochemically study of capillary hemangioma, pyogenic granuloma and cavernous hemangioma in the oral region: With special reference to vascular proliferation factors. Int J Oral-Med Sci. 2011;9(3):241-251. doi: 10.5466/ijoms.9.241

38. Marla V, Shrestha A, Goel K, Shrestha S. The histopathological spectrum of pyogenic granuloma: A case series. Case Rep Dent. 2016;2016:1323798. doi: 10.1155/2016/1323798

39. Andreadis D, Lazaridi I, Anagnostou E, Poulopoulos A, Panta P, Patil S. Diode laser assisted excision of a gingival pyogenic granuloma: A case report. Clin Pract. 2019;9(3):1179. doi: 10.4081/cp.2019.1179

40. Rai S, Kaur M, Bhatnagar P. Laser: A powerful tool for treatment of pyogenic granuloma. J Cutan Aesthet Surg. 2011;4(2):144-147. doi: 10.4103/0974-2077.85044

41. Bhaskar SN, Jacoway JR. Pyogenic granuloma--clinical features, incidence, histology, and result of treatment: Report of 242 cases. J Oral Surg. 1966;24(5):391-398.

42. Asnaashari M, Mehdipour M, MoradiAbbasabadi F, Azari- Marhabi S. Expedited removal of pyogenic granuloma by diode laser in a pediatric patient. J Lasers Med Sci. 2015;6(1):40-44.