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Case report of a bleeding nasal polyp during pregnancy.


From the Division of Otorhinolaryngology, Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, SAR.

Reprint requests: Prof. Andrew van Hasselt Hasselt (hä`səlt), city (1991 pop. 66,611), capital of Limburg prov., NE Belgium, in the Campine region, a port on the Albert Canal. It is a commercial and industrial center and a rail junction. Hasselt was chartered in 1232. The Dutch defeated the Belgians there in 1831., Division of Otorhinolaryngology, Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories New Territories: see Hong Kong., Hong Kong, SAR. Phone: 852-2632-2628; fax: 852-2646-6312; e-mail: andrewvan@cuhk.edu.hk

Abstract

We report a case of a pregnant woman who had a pyogenic granuloma
actinic granuloma  a round lesion with a raised border seen on skin chronically exposed to sunlight.
granuloma annula´re  a benign, self-limited disease consisting of round granulomas of the dermis in groups, with papules or nodules, mainly seen in young girls.
 that had caused chronic epistaxis
ep·i·stax·es (-stksz) 
A nosebleed.
 for 1 week's duration. The lesion was excised and the patient recovered fully.

Case report

A 25-year-old woman came to the ENT department during the 20th week of her pregnancy. She had a 1-week history of left-sided nosebleeds, and she noted that her left nostril was blocked.

Examination revealed a red, lobulated lobulated /lob·u·lat·ed/ (lob´ul-at-id) made up of lobules. lesion that filled the left nostril (figure). Because of the history of bleeding and the fact that the lesion had rapidly increased in size, there was concern that it was a malignancy
1. a tendency to progress in virulence.
2. the quality of being malignant.
3. a cancer, especially one with the potential to cause death.


ma·lig·nan·cy (m
. The mass was excised while the patient was under a short period of general anesthesia. The lesion was based on a small pedicle attached to the nasal septum. Excision
1. Surgical removal by cutting, as of a tumor or a portion of a structure or organ. Also called exsection.
2. A recombination event in which a genetic element is removed.
 was straightforward. The patient reported immediate relief of her symptoms. Histology confirmed that the mass was a pyogenic granuloma. The woman's pregnancy proceeded uneventfully, and at 1-year followup followup - On Usenet, a posting generated in response to another posting (as opposed to a reply, which goes by e-mail rather than being broadcast). Followups include the ID of the parent message in their headers; smart news-readers can use this information to present Usenet news in "conversation" sequence rather than order-of-arrival. See thread., there was no evidence of recurrence.

Discussion

Although this type of lesion is often referred to as a granuloma gravidarum or a bleeding polypus of pregnancy, histologically this lesion is a pyogenic granuloma. Because it can grow rapidly and bleeds, it can be mistaken for a malignant lesion. Pyogenic granulomas appear to be hormone-dependent because those that are not excised resolve after pregnancy.

Pyogenic granulomas arise from a narrow base, usually on the nasal septum, and they are easily excised. Although they spontaneously regress after pregnancy, the worry of malignancy and the distress caused by the obstruction and epistaxis often dictates that excision is the optimal course of management.
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Article Details
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Author:Hasselt, Andrew van
Publication:Ear, Nose and Throat Journal
Article Type:Brief Article
Geographic Code:1USA
Date:Aug 1, 1999
Words:328
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