“Bleeding Polyp” of the Nasal Septum: A Case Report

Background and Aim: Inflammatory hemangioma of the nasal septum, known as “bleeding polyp” or “pyogenic granuloma,” is an uncommon lesion in adults. Pyogenic granuloma is a polypoid capillary hemangioma, sometimes called lobular capillary hemangioma, which is seen on skin and mucosal surfaces. These lesions occur in the gingiva, most commonly the fingers, lips, face, nasal cavities, and tongue. Sixty percent of nasal lesions arise on the septum and can appear with epistaxis. The aim of this study is to report an interesting case of a lobular capillary hemangioma of the nasal septum, including its clinical appearance, diagnostic access, and surgical treatment.

Case Report: A 48-year-old woman presented with a short history of unilateral nasal obstruction, epistaxis, and nasal discharge. A thorough medical history and clinical and endoscopic examination were obtained. The radiographic study was conducted with a CT scan. The mass was completely excised without any difficulty under general anesthesia using the Cottle technique. The patient remained free of symptoms at a 6-month follow-up.

Conclusions: This uncommon lesion should be considered in the differential diagnosis of a rapidly growing haemorrhagica lesion within the nasal cavity. Histologically, pyogenic granuloma consists of circumscribed aggregates of capillaries arranged in lobules. Clinical and histological diagnostic pitfalls occur frequently. Surgical excision is the treatment of choice; incomplete resection can lead to recurrence.