Pyogenic Granuloma / Mucocoele / Haemangioma of the Mouth

Pyogenic granuloma

May occur on the gums or oral mucosa of the lips, looking like a cutaneous pyogenic granuloma (also associated with minor trauma). Best treated by excision.

Haemangioma

Appears as a dark blue/purple, sessile or nodular swelling anywhere in and around the mouth, especially the vermilion border of the lips, floor of the mouth, and tongue. Blanches on pressure. No treatment needed except for pressing cosmetic reasons — copious bleeding can occur with attempted removal.

Mucocoele (retention/mucous cysts)

Transparent, mucous-filled, dome-shaped lesions. Most commonly occur on the inner surface of the lower lip (75% of cases), but can also appear on the floor of the mouth (where they’re called ranulae), gingiva, buccal mucosa, or tongue. Painless but bothersome, as patients notice the irregularity. Usually result from trauma to the mouth injuring tiny salivary ducts inside the lip — lip sucking/biting.

Management: superficial mucocoeles usually resolve spontaneously, needing no specific treatment. If frequently recurrent and problematic, options include surgical removal, marsupialisation, cryosurgery, laser ablation, or micro-marsupialisation.

Others occur on the tonsils, usually appearing as sessile yellow swellings.