A Huge Oropharyngeal Pyogenic Granuloma in a Patient Presenting with Dysphagia.

Abstract

A 39-year-old woman experienced dyspnea and progressive dysphagia for 1year. Dysphagia appeared for solid foods at the beginning but advanced for liquids. She described 17kg weight loss in the past 6months and her current weight was 38kg [body mass index (BMI) 16kg/m2]. Dyspnea presented with effort and lying was included after 1month. There was no disease or surgery except chronic hepatitis C in her medical history. Physical examination revealed hyponasal speech and a mass beside the tongue base. A smoothly surfaced 4×3-cm vascular mass in oropharynx was determined in endoscopic examination. The mass was mobile and occupied 80% of oropharyngeal area. Contrast-enhanced computed tomography revealed hypervascular 4×4×3cm pedunculated (8×13mm) mass arising from the right tongue base. The mass and the surrounding mucosa with a thin layer of tongue musculature were excised using cold instrumentation and bipolar cautery. Histologically the mass was reported as pyogenic granuloma (PG). This is the first study to report on oropharyngeal PG causing obvious weight loss in literature.