OBJECTIVE: This report describes a case of pyogenic granuloma and the associated treatment in the context of a literature review. CASE REPORT: JRS, a 12-year-old white girl, born and residing in Zé Doca-MA, sought service at the ENT Clinic ORL Bosaipo. She presented complaining of a tumor in the left nasal cavity that had been growing slowly over the previous 4 months, causing frequent nasal obstruction and epistaxis. The tumor (1.0 cm × 0.7 cm × 0.4 cm) was surgically excised followed by electrocoagulation. Anatomo-pathologic analysis revealed a well-perfused, hyperplastic lesion supported on loose tissue, edema, and mixed inflammatory infiltrate, comprising lymphocytes, plasma cells, and neutrophils. The surrounding epithelium was ulcerated. These results were suggestive of a diagnosis of pyogenic granuloma. CONCLUSION: Pyogenic granuloma, also known as lobular capillary hemangioma, is a benign vascular proliferation that is reactive and non-neoplastic, affecting the skin and mucous membranes, especially in the oral and nasal cavities. The condition is uncommon in children. The condition is most common in pregnant women, women ages >40 years and men aged <18 years. When found in the nasal cavity, the growth typically localizes to Little's area or plexus Kiesselbach, followed by the inferior turbinate. The causes can involve trauma, viral infections, chronic ulcers, and female hormonal imbalance. The lesion is friable, lobulated or flat, pedunculated, nodulated, or ulcerated. Common symptoms include unilateral nasal obstruction; bleeding, purulent-bloody rhinorrhea; cacosmia; and, in severe cases, ulcerative lesions of the nasal mucosa, cartilage, and even surrounding bone. The treatment is surgical excision or electrocoagulation. When treating pregnant women with few symptoms, treatment can be delayed because the lesion is likely to disappear completely or in part at the end of the pregnancy.
