A case of gigantic pyogenic granuloma with three recurrences in the lower anterior gingiva is presented. Surgical wide excision of the lesion is the treatment of choice. The tumour must be excised down to the periosteum and the irritants around it removed to avoid recurrence. A contributing factor to the gigantic lesion is hormonal changes during pregnancy. Long-term review for 18 months after the third surgery showed no evidence of recurrence at the surgical site.
Choriocarcinoma is a rare neoplasia with a tendency of distant metastasis although highly sensitive to chemotherapy renders a good prognosis and outcome. Lungs, liver and cerebral metastasis are commonly implicated with maxillofacial region rarely involved. We illustrate a case of overwhelming metastatic choriocarcinoma to lungs, liver, brain and to the extreme of gum metastasis. Decompressive craniectomy for intracranial bleeding, multiple transfusions to correct anaemia and coagulopathy were done before high-risk-regime chemotherapy. Despite this, due to fulminant multi-organs involvement she finally succumbed to death. In conclusion, gum bleeding in choriocarcinoma may suggest metastasis and poor prognosis.