Management Large Lobular Hemangioma of Upper Lip in Pregnancy Providing a Clinical Insight for Patient Care: A Case Report and Literature Review

The term Pyogenic granuloma is described as a tumor-like growth that sequel from an exaggerated response to minor trauma or ongoing irritation. The term "pyogenic granuloma" is mislabelled, as it is not associated with pus formation. It is more accurately referred to as Lobular Capillary Hemangioma. Lobular capillary hemangioma consists of inflamed fibrovascular tissue and is known by several names, including pregnancy epulis, giant cell granuloma, and papillary hyperplasia, with the most common being pyogenic granuloma. We report a rare case of capillary hemangioma presenting as a rapidly enlarging upper lip mass in a pregnant female. These vascular proliferations show increased incidence during pregnancy, attributed to elevated levels of estrogen and progesterone. Management strategies for capillary hemangiomas include surgical excision, laser ablation, sclerotherapy, and embolization. Surgical excision remains the gold standard, particularly for lesions causing functional impairment, cosmetic concerns, or recurrent bleeding and this approach offers the lowest recurrence rate and facilitates histopathological evaluation of the lesion. Although the risk of intraoperative hemorrhage remains a consideration, particularly in highly vascular lesions, meticulous surgical technique and preparedness with hemostatic measures (e.g., electrocautery, diathermy) can mitigate complications.