Journal of Medicine, Radiology, Pathology & Surgery (2017), 4, 10–13 10 Journal of Medicine, Radiology, Pathology & Surgery ● Vol. 4:3 ● May-Jun 2017 CASE REPORT Extragingival pyogenic granuloma on the tongue: A rare case report and review of literature Tejavathi Nagaraj, Keerthi Irugu, Durga Rajaram Okade, Swathi Saxena Department of Oral Medicine and Radiology, Sri Rajiv Gandhi College of Dental Sciences & Hospital, Cholanagar, Bengaluru, Karnataka, India Abstract Pyogenic granuloma is a benign oral sof tissue infammatory hyperplasia. It occurs as a tumor-like proliferation of the oral mucosa, which usually seen in response to nonspecifc infection. Due to its high frequency in the oral cavity, this is a case of pyogenic granuloma in a male patient aged 13 years which occurred on the lateral border of tongue. Clinical and histopathologic features and also diferential diagnosis are mentioned in this case report which helps in the treating the lesion and also reducing the chances of recurrence. Keywords: Hyperplasia, pyogenic granuloma, recurrence Correspondence: Dr. Keerthi Irugu, Department of Oral Medicine and Radiology, Sri Rajiv Gandhi College of Dental Sciences & Hospital, Cholanagar, Bengaluru - 560 032, Karnataka, India. Phone: +91-9916903205. E-mail: keerthi.irugu@gmail.com Received: 17 April 2017; Accepted: 28 May 2017 doi: 10.15713/ins.jmrps.94 Introduction Pyogenic granuloma is a well-known lesion of the oral cavity. Tis term is a misnomer because clinically there is no pus formation and histologically does not bear any resemblance to granulomatous lesion. [1] Te gingiva is a common site of occurrence. Extra gingivally, other sites such as lips, tongue, palate, and buccal mucosa are also afected due to any trauma in these sites. In the oral cavity, it is the second most common lesion. Although clinically it appears as a tumor-like growth it has no malignant potential. Case Report A male patient aged 13 years came to the department of oral medicine and maxillofacial radiology with the complaint of growth in the lef lateral region of the tongue since a duration of 3 months. Te growth was initially small and slowly growing and atained the present size. Te patient reported discomfort associated with the growth which increased during chewing food. Medical history was noncontributory. Extraorally bilateral symmetry is noticed as shown in Figure 1. Intraorally, a single well-circumscribed nonpedunculated growth noticed on the lef lateral border of tongue measuring about 1.5 cm × 2 cm seen extending from teeth region from mesial aspect of 74 to mesial aspect of 75 [Figure 2]. Te inspectory fndings were confrmed with palpation. On palpation, the growth was frm in consistency, nontender and there was no discharge. Bleeding on provocation was negative. Hard tissue examination revealed stains and calculus and sharp cusps irritational 74 and 75. With the above clinical fndings and history, we came to a provisional diagnosis of irritational fbroma. Excisional biopsy was done under local anesthesia as shown in Figures 3 and 4, and the excised specimen was sent for histopathology. Histopathology showed a hyperplastic, parakeratinized stratifed squamous epithelium with acanthosis, and pseudoepitheliomatous hyperplasia. Te underlying fbrovascular connective tissue was composed of numerous proliferating capillaries; dense mixed infammatory infltrate predominantly lymphocytes and extravasated RBC’s. Based on the histopathological report, we came to fnal diagnosis of pyogenic granuloma. Afer a week the patient was recalled, and the excised area was observed for healing as shown in Figure 5. Healing was satisfactory.