Definition, Epidemiology, Pattern of Growth

First reported in the nineteenth century by Poncet and Dor (1897) with the term of botryomycoma, pyo-genic granuloma is a benign, rapidly growing lesion, characterized by a lobular proliferation of capillaries (Mills et al. 1980), also known with several other names (i.e., telangiectatic granuloma, granuloma pe-dunculatum, infected granuloma). Even though the term "pyogenic granuloma" is the most commonly used, it does not address the true nature of the lesion, which is neither the result of a bacterial infection nor a true granuloma (El-Sayed and Al-Serhani 1997).

In 1980, the synonym "lobular capillary heman-gioma" was proposed as an adequate term to indicate a lesion which consists of capillaries arranged in lobules and separated by a loose connective tissue stroma, often infiltrated by inflammatory cells (Mills et al. 1980).

Lobular capillary hemangioma mainly affects the female population, with a peak incidence in the third decade (range: 11-65 years) (Leyden and Master 1973; El-Sayed and Al-Serhani 1997). The lesion may involve skin and mucosa, most often in the oral cavity, where the lips are more frequently affected (about 38% of patients). Sinonasal localization ranges from 7% to 29%, the anterior portion of the nasal septum and the turbinates being the most frequently involved areas (Jafek et al. 1977; Mills et al. 1980).

The pathogenesis of the lesion is still unclear. Nasal trauma and hormonal imbalances have been postulated as possible etiologic factors (Lance et al. 1992). The second hypothesis seems to play a role in a variant of lobular capillary hemangioma known as granuloma gravidarum, which usually appears on the gingival mucosa during pregnancy (Miller et al. 1999).

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