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Tumor Discovery PG of maxillary median gingiva in a pediatric patient

in a lobular shape based on clinicopathological and his treatment. We collaborated with the pediatrician who
immunohistochemical characteristics, and that these two was responsible for the examination and treatment of the
lesion types differ histologically per their pathogenesis. patient. We strived to provide prompt yet comprehensive
36
Our case was categorized as non-LCH. However, Kawachi care to the patient while reducing procedures as much as
found that capillary hemangiomas and PG differ from possible. Our tailored treatment plan proved to be effective
each other because of their distinct expression of vascular as a result of the smooth handling of the perioperative
endothelial growth factors. They also concluded that treatment and management for the patient.
37
capillary hemangiomas showed proliferating activity of
capillaries, such as endothelial cells and pericyte-like 4. Conclusion
perivascular cells, with the appearance of mast cells and We presented a case of PG in the anterior maxillary
lobules, whereas PG exhibited remarkable proliferative region of a child, contributing significantly to the relevant
activity mainly of endothelial cells and inflammatory literature. To rule out malignancy, it is important for
changes. However, it is currently unclear whether capillary physicians to collaborate closely with pediatricians to
hemangiomas and PG are of the same pathological promptly examine and treat the rapidly growing tumors in
classification. children, which manifest possible signs of malignancy, as
The development of PG can be categorized according in the present case.
to their respective macroscopic findings into three distinct
stages, namely (i) cellular phase, (ii) capillary phase/ Acknowledgments
vascular phase, and (iii) involution phase. Differential None.
38
diagnoses in the oral region include benign reactive
lesions, such as fibromas, hemangiomas, and peripheral Funding
giant cell granulomas, as well as malignant tumors, such None.
as metastatic tumors of the oral soft tissue and Kaposi’s
sarcoma. A histopathological examination is essential to Conflict of interest
2,39
distinguish rapidly growing PG from malignant tumors, as
in the present case. In our case, an excisional biopsy was The authors declare no conflicts of interest.
performed to avoid having to perform a second procedure Author contributions
if the tumor was not malignant.
Conceptualization: Takeshi Karube, Seiji Asoda
Treatment options for PG include electrocautery,
electrocoagulation, radiation therapy, and cryotherapy, 28,40 Data curation: Takeshi Karube, Terumi Takeuchi, Tatsuya
but resection of the lesion together with the surrounding Sakaguchi, Koki Furuya
healthy tissue has become a prevailing treatment approach Supervision: Taneaki Nakagawa, Seiji Asoda
in recent years. However, inadequate resection may result Writing – original draft: Takeshi Karube, Seiji Asoda
in rapid recurrence. The recurrence rate of PG has been Writing – review & editing: Takeshi Karube, Kaori Yago,
reported to be 6% – 16%. Accordingly, a radical cure of Hajime Okita, Seiji Asoda
3,41
the initial resection is important. Furthermore, Asnaashari Ethics approval and consent to participate
et al. concluded that using lasers for PG lesion removal
could reduce stress and fear among pediatric patients and Not applicable.
minimize discomfort both during and after surgery. In
42
the aforementioned 26 cases of pediatric PG, resection or Consent for publication
excision was performed in most cases, with only one case Informed consent has been obtained from the patient for
reporting recurrence within the follow-up period. publication of this case report.
For a PG lesion manifesting rapid growth, as in our Availability of data
case, a biopsy is required to rule out malignancy. However,
physicians should anticipate tougher restrictions in terms The data can be requested from the corresponding author
of facilities, examinations, and treatments if the patient is a following reasonable request.
child. In addition, it is important for health-care personnel
to cater to the mental health needs of the affected children References
and their families. In the present case, the patient was 1. Angelopoulos AP. Pyogenic granuloma of the oral cavity:
admitted to our hospital because pediatric hospitalization Statistical analysis of its clinical features. J Oral Surg.
was not feasible at the previous facility which tended to 1971;29(12):840-847.

Volume 3 Issue 2 (2024) 5 doi: 10.36922/td.2213