Pyogenic Granuloma of Nasal Septum: A Case Report and Review of Literature

Ramabhadraiah Anil Kumar, Myle Mahesh Babu, Palegar Rayadurga Venkatarajamma, Urvashi Mishra

Department of ENT, Bangalore Medical College & Research Institute, Bangalore, India.

DOI: 10.4236/ijohns.2014.34035                

Abstract

Pyogenic granuloma is a rapidly growing hyperplastic, vascular proliferation of the skin or mucous membrane. A benign lesion of unknown aetiology commonly associated with pregnancy, oral contraceptives and trauma. While lesions occur frequently in oral cavity, occurrence in the nasal septum is rarely reported. We report a case of 38-year-old male (known case of active pulmonary tuberculosis on anti-tubercular therapy) who presented with unilateral pyogenic granuloma of the anterior nasal septum with unilateral nasal obstruction. We emphasize that the rarely seen lobular capillary hemangioma (pyogenic granuloma) must be kept in mind in the differential diagnosis of a rapidly growing mass of the nasal cavity, even without history of epistaxis. Here we report an uncommon case and review current literature regarding aetiology, site and role of rifampicin in pyogenic granuloma.

Keywords

Pyogenic Granuloma, Nasal Obstruction, Vestibule

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Poncet, A. and Dor, L. (1897) Botryomycose Humaine. Rev Chir (Paris), 18, 996.
[2]	Hartzell, M.B. (1974) Granulation Pyogenicum (Botryomycosis of French Authors). J Cutaneous Dis, 22, 520-523.
[3]	Puxeddu, R., Berlucchi, M., Ledda, G.P., Parodo, G., Farina, D. and Nicolai, P. (2006) Lobular Capillary Hemangioma of the Nasal Cavity: A Retrospective Study on 40 Patients. American Journal of Rhinology, 20, 480-484. http://dx.doi.org/10.2500/ajr.2006.20.2878
[4]	Mills, S.E., Cooper, P.H. and Fechner, R.E. (1980) Lobular Capillary Hemangioma: The Underlying Lesion of Pyogenic Granuloma. A Study of 73 Cases from the Oral and Nasal Mucous Membranes. The American Journal of Surgical Pathology, 4, 470-479. http://dx.doi.org/10.1097/00000478-198010000-00007
[5]	Patrice, S.J., Wiss, K. and Mulliken, J.B. (1991) Pyogenic Granuloma (Lobular Capillary Hemangioma): A Clinico-Pathologic Study of 178 Cases. Pediatric Dermatology, 8, 267-276. http://dx.doi.org/10.1111/j.1525-1470.1991.tb00931.x
[6]	Requena, L. and Sangueza, O.P. (1997) Cutaneous Vascular Proliferation, Part II. Hyperplasias and Benign Neoplasm. Journal of the American Academy of Dermatology, 37, 887-922. http://dx.doi.org/10.1016/S0190-9622(97)70065-3
[7]	Bhattacharyya, N., Wenokur, R.K. and Goodman, M.L. (1997) Endoscopic Excision of a Giant Pyogenic Granuloma of the Nasal Cavity Caused by Nasal Packing. Rhinology, 35, 44-45.
[8]	Lee, H.M., Lee, S.H. and Hwang, S.J. (2002) A Giant Pyogenic Granuloma in the Nasal Cavity Caused by Nasal Packing. European Archives of Oto-Rhino-Laryngology, 259, 231-233. http://dx.doi.org/10.1007/s00405-001-0442-x
[9]	Neves-Pinto, R.M., Carvalho, A., Araujo, E., Alberto, C., De Oliveira, B. and De Carvalho, G.A. (2005) Nasal Septum Giant Pyogenic Granuloma after a Long Lasting Nasal Intubation: Case Report. Rhinology, 43, 66-69.
[10]	Kumar Ghosh, S. and Bandyopadhyay, D. (2012) Granuloma Pyogenicum as a Complication of Decorative Nose Piercing: Report of Eight Cases from Eastern India. Journal of Cutaneous Medicine and Surgery, 16, 197-200.
[11]	Delbrouck, C., Chamiec, M., Hassid, S. and Ghanooni, R. (2011) Lobular Capillary Haemangioma of the Nasal Cavity during Pregnancy. Journal of Laryngology and Otology, 125, 973-977.
[12]	Chiller, K.G., Passaro, D. and Frieden, I.J. (2002) Hemangiomas of Infancy: Clinical Characteristics, Morphologic Subtypes, and Their Relationship to Race, Ethnicity and Sex. Archives of Dermatology, 138, 1567-1576. http://dx.doi.org/10.1001/archderm.138.12.1567
[13]	Noubom, M., Kenfack, B., Donfack, J.H., Nembot, F.D. and Sando, Z. (2013) Clinical Case of Botryomycome Fulminant at the Center of Diagnostic and Treatment of Tuberculosis of Baleng (West-Cameroon). The Pan African Medical Journal, 14, 131.