A Sheep in Wolf's Clothing: Lobular Pyogenic Granuloma Masquerading Nodular Amelanotic Melanoma

Tumor masquerading is a common phenomenon seen in clinical dermatology. While amelanotic melanoma is known to simulate pyogenic granuloma, a benign vascular tumour, the contrary has been reported exceptionally scarce.

We present a 52-year-old woman with a slow-growing lesion on her right flank, which developed over 12 months. On examination, we observed a large exophytic, easily bleeding tumour on the right flank, that resembled amelanotic malignant melanoma. Histologic analysis after complete excision of the lesion confirmed a pyogenic granuloma of the lobular capillary hemangioma subtype. In the present case masquerading of the lesion went to the better site after histologic investigations despite the delay of diagnosis caused by the patients.

Nevertheless, the diagnosis of uncertain lesions needs a rapid histologic analysis to gain the best possible prognosis for the patient.