How would you treat this tumor that developed at the site of trauma?

Case :

This tumor has developed at the site of incidental trauma on this adolescent's forearm. The lesion is growing rapidly and bleeds profusely after minimal trauma.

What is it--and what should you do about it?


(Answer on next page.)

Case: This is a pyogenic granuloma. This patient's tumor is polypoid, but others may appear to be exuberant granulation tissue.

Pyogenic granulomas usually occur at sites of incidental trauma and are "growths" beyond the site of injury. They are friable, bright red tumors that are often surrounded by a collarette of hyperplastic epithelium. They grow rapidly and usually have an eroded surface. They are most commonly located on the fingers, toes, and lips. Histologically, these tumors are proliferations of capillaries in edematous stroma with many neutrophils.

Pyogenic granulomas are removed surgically, with destruction of the vascular base. The tumor should be submitted for histologic assessment. The differential diagnosis is that of rapidly proliferating tumors, such as amelanotic melanoma.