When a Bump on the Lip Becomes a Rapidly Growing Tumor

Jennifer Tatum thought little of the red bump that appeared on her lower lip soon after a bout of dry, chapped lips. However, nothing could have prepared her for the ordeal she was about to undergo. Over the course of the next two weeks, the bump slowly enlarged and became hypervascular, causing bleeding nearly every night on her pillow. She was initially treated by her dermatologist, who performed a shave biopsy of the lesion, and she was told to come back in two weeks for a check-up.

By the following week the red bump had already returned. The next week on follow-up the bump was now twice its original size. Fortunately her dermatologist acted quickly and referred her the same day to Gregory Levitin, MD, Director of the Vascular Birthmarks and Malformations Program for the Mount Sinai Health System. Looking over a series of photos Jennifer had assembled of her lip, Dr. Levitin realized this was an unusual case of a rapidly progressing pyogenic granuloma, a type of vascular tumor that can arise from a site of local trauma.

“When Jennifer came to see me, she had already undergone a minimally invasive procedure which often cures these types of minor vascular tumors. However in this case, the recurrence was already worse than the initial disease, and we knew we had to act quickly,” explained Dr. Levitin. “Complicating matters, Mrs. Tatum was 27-weeks pregnant, making general anesthesia a non-option.”

“I was extremely nervous about having to undergo a surgical procedure during pregnancy,” recalls Jennifer. “However, I could not afford to wait any longer, as the tumor was growing by the day and bleeding every night. After meeting with Dr. Levitin, he assured me this could be done in a controlled setting under local anesthesia, and that both myself and my child would be fine.”

Five days later, Dr. Levitin brought Jennifer to the operating room at New York Eye and Ear Infirmary of Mount Sinai for the procedure. However in that short time, the lesion had doubled in size again, causing him to change his approach. “At the initial visit, I determined that the granuloma needed to be removed surgically, but would have to be done while Jennifer was awake and under local anesthesia due to her pregnancy,” said Dr. Levitin. “By the time we met again in the operating room, I had to change the entire game plan in order to remove the much larger lesion.”

“I felt confident in Dr. Levitin from the first time we met,” said Jennifer, “so when he explained that he was going to have to make a bigger scar, I trusted that he knew what was best, as I could not afford to wait even another day. He even talked to me during the surgery, helping me feel calm throughout.”

Jennifer could not be happier with the positive outcome of her procedure.

“The result is simply amazing! I’ve had so many compliments from people who knew what I was going through.” she continued. “I was told to wait a month for it to fully heal, but after just a week it already looks normal, and the scar is perfect. Dr. Levitin is a gifted surgeon, and my husband and I couldn’t be more excited to have this behind us.”