Rectal Pyogenic Granuloma

Daniela Elena Serban1, Marcel Tantau2, Nicolae Miu1, Petre Florescu3, Cristian Fedorczuk4
1) 2nd Pediatric Clinic. 2) 3rd Medical Clinic. 3) Department of Morphopathology, University of Medicine and Pharmacy. 4) Children's Hospital, Cluj-Napoca

Abstract

Although a common lesion of the skin and oral cavity, pyogenic granuloma has been reported in only 15 cases in the gastrointestinal tract, 3 of them being colorectal adult cases. To the best of our knowledge, no colorectal pediatric case has been described.
We report on pediatric rectal pyogenic granuloma cases. To determine if there are possible peculiarities of these pyogenic granuloma, we retrospectively studied clinical, endoscopic and histologic features of all cases found to have polyps at colonoscopy, over a 3-year period.
We detected 11 children with colorectal polyps. From the 8 polyps considered colonoscopically as juvenile, microscopically 2 had a typical appearance of pyogenic granuloma and in a polyp related to mucosal prolapse syndrome, a small area of pyogenic granuloma was also found. No peculiar flora was detected in the stool. No recurrent lesions have appeared at follow-up colonoscopy.
Our report suggests that colorectal pyogenic granuloma is not as rare as formerly believed, since we have been able to detect two cases in our small series. The pyogenic granuloma is not a lesion "per se"; it could appear in any area of mucosal ulceration, in the presence of a peculiar attenuated local flora, that needs to be further studied. The clinical and colonoscopic features are not distinct for pyogenic granuloma; therefore, microscopic examination is required. The treatment of choice of gastrointestinal pyogenic granuloma is complete endoscopic polypectomy.

Key words

Pyogenic granuloma - colorectum - children