Extragingival Vascular Lesion on the Buccal Mucosa in an Adult Male: An Approach to Diagnosis

Background Pyogenic granuloma (PG) is a benign vascular proliferative lesion that predominantly affects the gingiva. Extragingival occurrence in the buccal mucosa is uncommon, and large lesions at this site are rarely documented. This case report describes an unusually large extragingival PG in the buccal mucosa, emphasizing the diagnostic challenges and management approach.Case Presentation A male patient in his sixth decade presented with a three-month history of a progressively enlarging mass in the left cheek. Clinical examination revealed a pedunculated, 3 × 4 cm pale pink lesion with erythematous areas and grayish-white patches on the buccal mucosa. Based on clinical features, a provisional diagnosis of traumatic fibroma was established. Complete surgical excision was performed under local anesthesia, and histopathological examination confirmed the diagnosis of pyogenic granuloma. Postoperative recovery was uneventful, with satisfactory healing and no recurrence during follow-up.Conclusion This case highlights the occurrence of pyogenic granuloma at an unusual extragingival site with an uncommonly large size compared to previously reported cases. It underscores the importance of including PG in the differential diagnosis of non-gingival oral lesions. Accurate diagnosis through histopathological confirmation and complete surgical excision are essential for successful management and prevention of recurrence.