Sclerosed pyogenic granuloma of the gingiva in a hypoxic-ischemic encephalopathy patient

Pyogenic granuloma (PG) is a common vascular lesion of the oral cavity that is reactive rather than neoplastic in nature. It commonly develops in response to trauma, chronic irritation, or hormonal influences and shows a higher prevalence in females. The lesion is more frequently observed in the mandibular region than in the maxilla. Standard management includes the elimination of local irritants and complete surgical excision. This case report describes the case of a 45-year-old male who presented with a firm, painless gingival swelling in the maxillary region, associated with localized alveolar bone loss. The patient had a medical history of hypoxic ischemic encephalopathy with associated intellectual disability, a nonprogressive neurological condition that may contribute to compromised oral hygiene and increased susceptibility to chronic irritation. In addition, the patient’s long-term tobacco use may have further exacerbated local inflammation, contributing to lesion development. Histopathological examination confirmed the diagnosis of sclerosed PG, characterized by extensive collagen deposition and a reduced vascular component. Complete surgical excision of the lesion, along with thorough debridement and elimination of local irritants, was performed. The patient exhibited uneventful healing and showed no evidence of recurrence during a 1-year follow-up period. This case highlights the importance of accurate diagnosis and comprehensive management in ensuring favorable long-term outcomes.