Pyogenic Granuloma — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

EasyOral PathologyPyogenic GranulomaORE Part 1

A patient presents with a painless, sessile, exophytic growth on the gingiva adjacent to the lower left canine. It is red-purple in colour, bleeds easily on contact, and has been growing rapidly over 4 weeks. She is 7 months pregnant. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Pyogenic granuloma (pregnancy epulis)

Explanation lettering: D = shown as A · A = shown as B · B = shown as C · E = shown as D · C = shown as E

The diagnosis is pyogenic granuloma (pregnancy epulis). The key discriminators are: (1) pregnancy in the third trimester, (2) rapid growth over weeks on the gingiva, (3) red-purple friable appearance, and (4) easy bleeding. These features are pathognomonic for pregnancy-associated epulis, driven by hormonally mediated increases in vascular endothelial growth factor (VEGF). Peripheral giant cell granuloma (B) and fibrous epulis (C) are non-vascular benign lesions not associated with pregnancy and lacking the red-purple friable character. Squamous cell carcinoma (D) is painless growth is atypical for malignancy; pregnancy is a protective factor. Kaposi sarcoma (E) is not pregnancy-associated and requires HHV-8. The diagnosis is confirmed histologically post-treatment; many lesions regress spontaneously postpartum.

Reference: Pyogenic Granuloma (Lobular Capillary Hemangioma), StatPearls/PubMed Central, 2020–2025; https://pubmed.ncbi.nlm.nih.gov/32310537/; supported by assessment of angiogenic markers in pregnancy tumors, PubMed 23623199, 2013, and case series of mandibular anterior presentations, PMC 10697180 & PMC 10864220, 2023–2024.