Alveolar pyogenic granuloma: review and report of a case.

A large exophytic bone-resorbing lesion was discovered in the oral cavity of an institutionalized 33-year-old male. An excisional biopsy under general anesthesia was performed. Frozen and permanent histologic sections confirmed a reactive gingival fibroma consistent with a pyogenic granuloma. This lesion is unusual in that it attained a very large size and caused marked remodeling of the alveolar bone of the mandible. Of interest as well, this highly vascular lesion was found to have numerous feeding vessels from the alveolar bone. A retained tooth root was encountered within the lesion, presumably the etiologic factor producing this lesion. A differential diagnosis is presented and discussed. The lesion should be of particular interest to otolaryngologists who deal with intraoral lesions and their treatment, since it illustrates an extreme presentation of a totally benign process.