Aggressive pregnancy tumor mimicking a malignant neoplasm: a case report.

AIM: The aim of this report is to present the management of an aggressive, highly proliferative pregnancy tumor with clinical and radiographic characteristics highly suggestive of a malignant neoplasm.

BACKGROUND

Pregnancy tumor is a benign hyperplastic gingival lesion occurring during pregnancy that is indistinguishable from a pyogenic granuloma arising in nonpregnant females, or in males. The lesion usually grows over a few months and tends to bleed.

CASE DESCRIPTION: A 28-year-old woman at four months of gestation was referred for a massive gingival swelling (5.5 cm in greatest diameter) on the mandibular left side. The lesion was painful and continued to grow very rapidly over a three-week period, with spontaneous bleeding, and it interfered with speech and mastication. Advanced alveolar bone loss also was found beneath the lesion. A malignant process was suspected, and an incisional biopsy revealed a pregnancy tumor. The lesion was excised under general anesthesia during the pregnancy with no untoward reactions.

SUMMARY: Pregnancy tumor represents an important differential diagnosis of oral masses and can behave in a very aggressive fashion, mimicking a malignant tumor.

CLINICAL SIGNIFICANCE: This lesion should always be included in the differential diagnosis of soft tissue masses in a pregnant woman even if the lesion is clinically very aggressive. It is acceptable practice to excise aggressive variants of this lesion during pregnancy to avoid distressing side effects.