Lobular Capillary Hemangioma of the Mandibular Gingiva: A Clinicopathological Report of an Unusual Buccolingual Presentation

Abstract

Lobular capillary hemangioma (LCH), commonly known as pyogenic granuloma (PG), is a benign reactive vascular proliferation frequently affecting the oral cavity, particularly the gingiva. A 36-year-old female presented with a painless, bleeding gingival growth in the mandibular premolar region of 2 months’ duration. Intraoral examination revealed a 10 × 8 mm exophytic lesion involving the buccal and lingual gingiva in relation to mandibular first and second premolars (34 and 35), extending up to the occlusal third. A provisional diagnosis of pyogenic granuloma was made, with peripheral giant cell granuloma, peripheral ossifying fibroma, irritation fibroma, and other reactive vascular lesions considered in the differential diagnosis. Complete surgical excision was performed under local anesthesia, and the specimen was submitted for histopathological examination. Microscopy revealed stratified squamous epithelium overlying fibrovascular connective tissue with numerous proliferating capillary-sized vascular channels lined by plump endothelial cells, inflammatory cell infiltration, and areas of surface ulceration and granulation tissue. These findings confirmed LCH. At 1-month follow-up, complete clinical healing was observed without residual or recurrent lesion. This case highlights the buccolingual presentation of LCH in the mandibular premolar region and emphasizes histopathological examination for definitive diagnosis.