A Case of Capillary Haemangioma of the Gingiva in a Six-year-old Child: A Diagnostic Challenge

Capillary haemangioma is a benign vascular lesion commonly observed in infancy but rarely reported in the oral cavity, especially on the gingiva. Because its clinical appearance can resemble more common reactive lesions, such as pyogenic granuloma, establishing a correct diagnosis in children can be difficult. In the present case report, the authors present the case of a six-year-old male who reported with intermittent gingival bleeding and a rapidly enlarging reddish, lobulated swelling in the posterior mandibular region. The lesion developed after minor trauma and the extraction of a primary molar, which further complicated the initial clinical impression. The lesion was soft, friable, and bled easily on manipulation, leading to an initial clinical diagnosis of pyogenic granuloma. Radiographic evaluation revealed no underlying bony involvement. Given the vascular nature of the lesion, careful surgical excision was performed under local anaesthesia. Histopathological examination revealed numerous irregular, endotheliallined capillary channels within a connective tissue stroma, confirming the diagnosis of capillary haemangioma. Postoperative healing was uneventful, with no evidence of recurrence on 2-month follow-up. Misdiagnosis of vascular lesions such as capillary haemangioma as reactive lesions like pyogenic granuloma may result in unexpected intraoperative bleeding and inadequate surgical planning, emphasising the need for careful evaluation and histopathological confirmation. The present case highlights the close clinical resemblance between capillary haemangioma and reactive gingival lesions and underscores the importance of histopathological examination for establishing a definitive diagnosis and guiding appropriate management in paediatric patients.