Surgical removal of giant cutaneous horn from a pyogenic granuloma
This video depicts the surgical excision of a pyogenic granuloma on the lower eyelid.
The patient was brought into the operating room and general anesthesia was induced,
the base of the lesion was injected with lidocaine and epinephrine. A warm compress
was applied to soften the crusted lesion. The crust was then gently elevated revealing
the giant pyogenic granuloma. A chalazion curette was used to completely remove the
lesion. A chalazion clamp was utilized to stabilize the lid and for hemostasis purposes.
Pyogenic granulomas, or lobular capillary hemangiomas, are highly vascularized benign tumors from tissues such as mucous membranes or skin.1 It will often appear as a red pedunculated papule and exhibit rapid growth over weeks to months, eventually stabilizing in size.1 They usually result after an injury or with certain medication use.1 In the present patient's case, the pyogenic granuloma growth left an exposed mucous membrane which allowed the production of a cutaneous horn. A cutaneous horn is a hyperkeratotic epithelial lesion without a bony component.2
A procedure to remove a pyogenic granuloma would be indicated if it was painful or an annoyance to the patient.1 Most common reason for removal is the frequent bleeding from these hemangiomas.1
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A thorough ocular history and family history should be obtained
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Potential of small scar from removal
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1. Sarwal P, Lapumnuaypol K. Pyogenic Granuloma. [Updated 2022 Oct 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556077/
2. Thiers BH, Strat N, Snyder AN, et al. Cutaneous Horn. [Updated 2024 Feb 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563280/
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