The exuberant proliferation of granulation tissue produces a sessile or polypoid mucosal mass, a pyogenic granuloma, which is found in people of all ages. The increased frequency with which it is encountered in pregnancy accounts for the term "pregnancy tumor,'' but the absence of estrogen and progesterone cell surface receptors leaves the relationship to pregnancy unexplained: the cause is unknown. Although pyogenic granulomas may occur on any skin or mucosal surface, the oral mucosal and especially the gingiva are among the most common sites. Clinically, pyogenic granulomas present as an easily bleeding, red mass that ranges in size from a few millimeters to several centimeters and lasts for weeks or months. In dentulous areas, the lesion may partially encircle or form a collar around a tooth. The tongue, lips, and buccal mucosa are other common sites. Microscopic examination reveals a unicentric or polylobate proliferation of granulation tissue. The vessel size ranges from capillary to small venules. Much of the surface is ulcerated and inflammation spreads into the underlying vascular connective tissue. The term "pyogenic granuloma'' is misleading because pus is seldom encountered. The treatment is surgical excision, and the recurrence rate is unknown but is in the order of 10%. Pregnancy tumors may regress after parturition.
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