A diagnostic challenge: pyogenic granuloma or oral focal mucinosis.

To cite: Kumar M S, Kumar M H, Sivakumar V, et al. BMJ Case Rep Published online: [please include Day Month Year] doi:10.1136/ bcr-2015-210150 DESCRIPTION A 25-year-old female patient presented to the dental clinic with a painless gingival swelling in the right mandibular first molar (46) region (figure 1). The swelling had been present for the past 4 months. The medical and surgical histories were unremarkable. Intraoral examination revealed a reddish, sessile, firm, well-defined mass measuring 1.0 cm at its greatest dimension (figure 2). Panoramic radiographic examination showed no alterations in the underlying bone or in the adjacent teeth (figure 3). The first clinical impression at examination was that of pyogenic granuloma, irrational fibroma. Surgical excision of the lesion under local anaesthesia was planned. After administrating inferior alveolar nerve block on the right side, complete excision of the lesion was performed with a scalpel number 15. Minimal bleeding was encountered, which was controlled with a pressure pack. The surgical wound was sutured with 3-0 vicryl. The excised lesion was sent for histopathological examination. The H&E stained microscopic slide