Granuloma gravídico com proservação de 10 meses sem recidiva: relato de caso clínico

Abstract

Pyogenic granuloma is a non-neoplastic reactive lesion characterized by an exuberant proliferation of vascular tissue, usually triggered by local irritation, trauma, or hormonal changes. It presents as a reddish mass with a smooth or lobulated surface that bleeds easily on touch. It is more common on the gingival mucosa and shows a higher incidence in women, especially during pregnancy, when it is referred to as pregnancy granuloma. The aim of this study was to report a clinical case of pregnancy granuloma in a patient treated during the Stomatology Extension Curricular Activity at the School of Dentistry of the Federal University of Amazonas (UFAM). A 25-year-old female patient, leucoderma, presented with a voluminous area on the anterior vestibular gingival papilla between teeth 31 and 41. The lesion was asymptomatic, prone to bleeding, had been present for one year, increased in size during pregnancy, and showed no regression after childbirth (CAAE No. 89933825.6.0000.5020). Intraoral examination revealed a pedunculated, reddish lesion, firm on palpation, painless, measuring approximately 16 mm × 11 mm, with bleeding on touch, located in the interdental gingival papilla between teeth 31 and 41. Edematous and hyperemic gingiva, as well as the presence of biofilm and calculus in the affected region, were also observed. Radiographic examination revealed a radiolucent area at the level of the interproximal alveolar bone of the mandibular incisors, consistent with horizontal bone loss. Considering the lesion characteristics, anamnesis, and the literature, a clinical diagnostic hypothesis of pregnancy granuloma was established. The lesion was submitted to excisional biopsy and sent to the Department of Pathology and Legal Medicine of the UFAM School of Medicine, fixed in 10% formaldehyde, for histopathological analysis. Microscopic examination revealed stratified squamous epithelium with areas of atrophy, exulceration, and spongiosis, in addition to intense angiogenesis, fibroblastic proliferation, deposition of collagen fibers, and a nonspecific chronic inflammatory infiltrate predominantly composed of lymphocytes, plasma cells, and histiocytes, confirming the diagnosis of pregnancy granuloma. Ten months after surgical excision, the patient remains under follow-up, with no signs of recurrence.